中华护理杂志 ›› 2026, Vol. 61 ›› Issue (17): 2345-2350.DOI: 10.3761/j.issn.0254-1769.2026.17.006

• 标准与规范 • 上一篇    下一篇

抗肿瘤药物所致中性粒细胞减少患者感染预防指导专家共识

中华护理学会肿瘤护理专业委员会, 上海市抗癌协会肿瘤护理专业委员会 (执笔:王心茹1(), 张晓菊1, 陆宇晗1, 陆宇晗1, 陆箴琦2, 杨瑒)1,*()   

  1. 1 复旦大学附属肿瘤医院护理部复旦大学上海医学院肿瘤学系 上海市 200032
    2 北京大学肿瘤医院护理部 北京市 100142
  • 收稿日期:2026-03-05 出版日期:2026-09-10 发布日期:2026-09-03
  • *通讯作者: 杨瑒,E-mail: yy-sandra@163.com
  • 作者简介:王心茹:女,博士,主管护师,E-mail:wxrpumc@qq.com
  • 基金资助:
    上海抗癌协会护航计划(SACA-HH202401)

Expert consensus on guidance for infection prevention in patients with antineoplastic drug-induced neutropenia

Cancer Nursing Committee of Chinese Nursing Association, Cancer Nursing Committee of Shanghai Anti-Cancer Association (Writing Committee:WANG Xinru1(), ZHANG Xiaoju1, ZHANG Xiaoju1, LU Yuhan1, LU Zhenqi2, YANG Yang)1,*()   

  1. 1 Department of NursingFudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan UniversityShanghai 200032, China
    2 Department of NursingPeking University Cancer HospitalBeijing 100142, China.
  • Received:2026-03-05 Online:2026-09-10 Published:2026-09-03
  • * Corresponding author: YANG Yang,E-mail: yy-sandra@163.com
  • Funding program:
    Shanghai Anti-Cancer Association Nursing Support Program(SACA-HH202401)

摘要:

目的 编制“抗肿瘤药物所致中性粒细胞减少患者感染预防指导专家共识”(以下简称“共识”),旨在为护士开展相关健康教育提供依据。 方法 成立“共识”编写小组,严格遵循世界卫生组织标准版指南制订流程,经文献检索、质量评价、证据提取及整合形成“共识”初稿。2025年6—10月,邀请20名肿瘤医疗或护理、血液系统疾病医疗或护理、医院感染管理、营养学、中医学、药学等领域的专家进行2轮函询,并组织18名专家进行论证,形成“共识”终稿。 结果 2轮函询的有效问卷回收率均为100%,共收集228条修改意见,专家意见提出率分别为100%、90.00%;专家的权威系数分别为0.914、0.923;各条目的重要性评分均数分别为4.00~4.95、4.15~5.00分,变异系数分别为0.05~0.27、0~0.21;专家意见的肯德尔和谐系数分别为0.218、0.110(均P<0.001)。根据函询及论证专家建议修订“共识”内容,最终形成的“共识”包括治疗前感染风险告知、居家感染预防措施指导、症状监测与感染识别指导、用药指导、就医指导共5个方面的内容。 结论 该“共识”可为临床护士指导抗肿瘤药物所致中性粒细胞减少患者预防感染提供依据。

关键词: 抗肿瘤药物, 中性粒细胞减少, 感染预防, 自我管理, 肿瘤护理, 专家共识

Abstract:

Objective To develop an expert consensus on self-management guidance for infection prevention in patients with antineoplastic drug-induced neutropenia(hereinafter referred to as “consensus”),aiming to provide a reference for nurses to guide patients in self-managing infection prevention during neutropenia induced by antineoplastic therapy. Methods A “consensus” development group was established. In strict accordance with the World Health Organization standard guideline development process,a systematic literature search and quality assessment were conducted,and evidence on infection prevention self-management in patients with antineoplastic drug-induced neutropenia was extracted to form the initial draft of the “consensus”. From June to October 2025,2 rounds of expert consultation and a round of expert panel discussion were performed to revise and refine the “consensus”,resulting in the final version. Results The effective questionnaire response rate was 100% in both consultation rounds. A total of 228 revision suggestions were collected. The expert opinion submission rates were 100% and 90.00%;the expert authority coefficients were 0.914 and 0.923;and Kendall’s coefficients of concordance were 0.218 and 0.110(both P<0.001). The mean importance scores of all items ranged from 4.00 to 4.95 and 4.15 to 5.00,with coefficients of variation ranging from 0.05 to 0.27 and 0 to 0.21,respectively. Based on expert suggestions from the consultations and panel discussion,the “consensus” was revised. The final “consensus” includes guidance on 5 aspects:pre-treatment infection risk communication,home-based infection prevention measures,symptom monitoring and infection identification,medication use,and healthcare seeking measures. Conclusion This “consensus” serves as a reference for clinical nurses to guide patients undergoing antineoplastic therapy in self-managing infection prevention during neutropenia.

Key words: Antineoplastic Drug, Neutropenia, Infection Prevention, Self-Management, Oncologic Nursing, Expert Consensus