中华护理杂志 ›› 2024, Vol. 59 ›› Issue (4): 469-473.DOI: 10.3761/j.issn.0254-1769.2024.04.013

• 个案研究 • 上一篇    下一篇

1例胃癌患者使用免疫检查点抑制剂后发生细胞因子释放综合征的护理

朱慧娣(), 章梅云(), 江月红, 李贝贝, 徐巧英   

  1. 310013 杭州市 浙江大学医学院附属第一医院护理部
  • 收稿日期:2023-04-03 出版日期:2024-02-20 发布日期:2024-02-22
  • 通讯作者: 章梅云,E-mail:23472347@zju.edu.cn
  • 作者简介:朱慧娣:女,本科,副主任护师,护士长,E-mail:hzzhuhuidi0505@yeah.net
  • 基金资助:
    浙江省中医药科技计划项目(2021ZT003)

Nursing care of a patient with gastric cancer who developed cytokine release syndrome after the use of immune checkpoint inhibitors

ZHU Huidi(), ZHANG Meiyun(), JIANG Yuehong, LI Beiei, XU Qiaoying   

  • Received:2023-04-03 Online:2024-02-20 Published:2024-02-22

摘要:

总结1例胃癌患者使用免疫检查点抑制剂后发生细胞因子释放综合征的护理经验。护理要点:整体护理评估方案的制订,指导安全护理;兼顾出血和血栓,做好上消化道出血护理;对Ⅳ级口腔黏膜炎落实以清洁和抗感染为重点的护理策略;实施严重肺部病变的风险管理;做好激素的用药护理、感染的预防与护理和出院随访管理。患者住院52 d顺利出院,随访3个月,情况良好。

关键词: 胃癌, 免疫检查点抑制剂, 细胞因子释放综合征, 肿瘤护理

Abstract:

To summarize the nursing experience of a patient with gastric cancer who developed cytokine release syndrome after using immune checkpoint inhibitors. Key points of nursing care:development of nursing assessment decisions with a holistic view to guide safe nursing care;taking into account the contradiction between bleeding and thrombosis and providing good care for upper gastrointestinal bleeding;implementing a nursing strategy focusing on cleaning and anti-infection for IV oral mucositis;implementing risk management for severe pulmonary lesions;providing good hormone medication care and discharge follow-up management. The patient was successfully discharged on 52nd day with a 3-month follow-up in good condition.

Key words: Stomach Neoplasms, Immune Checkpoint Inhibitors, Cytokine Release Syndrome, Oncologic Nursing