关键词: 免疫相关不良事件, 心肌炎、肌炎及重症肌无力重叠综合征, 免疫检查点抑制剂, 肿瘤护理

Abstract:

To summarize the nursing experience for a patient with pulmonary large cell neuroendocrine carcinoma with myocarditis-myositis-myasthenia gravis overlapping syndrome after receiving immune checkpoint inhibitor therapy. Key points of nursing care are as follows：strengthening the identification of prodromal symptoms in the early stage to initiate rapid response；implementing targeted dynamic monitoring to remain vigilant against fatal complications，such as malignant arrhythmias and myasthenic crisis，given the multi-organ involvement；executing strict medication administration and refined adverse event management for high-dose glucocorticoids combined with intravenous immunoglobulin；conducting combined assessments of laboratory indicators，clinical symptoms，and neuromuscular functions at critical nodes during the corticosteroid tapering phase to ensure a safe transition；providing transitional home care and follow-up support post-discharge. Following systematic treatment and meticulous nursing care，the patient was discharged in a stable condition，with no recurrence observed during the follow-up period.

Key words: Immune-Related Adverse Events, Myocarditis-Myositis-Myasthenia Gravis Overlapping Syndrome, Immune Checkpoint Inhibitors, Oncologic Nursing