免疫联合靶向治疗患者重叠毒性护理鉴别及分诊策略的研究进展

doi:10.3761/j.issn.0254-1769.2026.20.019

摘要/Abstract

摘要：

免疫检查点抑制剂联合靶向治疗成为晚期肿瘤患者的标准治疗方案，其引发的“重叠毒性”因临床表现相似但病理机制不同，是临床护理评估的重点与难点。该文梳理重叠毒性的护理鉴别与分诊策略研究进展，提出基于“治疗—症状时间轴”与“症状簇”分析的鉴别框架。同时总结胃肠道、肝脏、皮肤及肾脏等靶器官的差异化护理要点，阐述护士主导的结构化分诊流程、诊断性治疗暂停策略及电子化患者报告结局在全程管理中的应用。在此基础上，分析多学科协作模式的价值及本土化护理体系的构建路径，旨在为提升肿瘤专科护士早期风险识别能力、建立适合国情的重叠毒性护理管理提供参考。

关键词: 免疫检查点抑制剂, 酪氨酸激酶抑制剂, 重叠毒性, 护理评估, 症状管理, 肿瘤护理

Abstract:

As the combination of immune checkpoint inhibitors and targeted therapy becomes the standard regimen for patients with advanced tumors，the resulting “overlapping toxicity” has become a focal point and challenge in clinical nursing assessment due to its similar clinical manifestations but distinct pathological mechanisms. This article reviews the research progress on nursing differentiation and triage strategies for overlapping toxicities. It proposes a differentiation framework based on the “treatment-symptom timeline” and “symptom cluster” analysis. Meanwhile，it summarizes the differentiated nursing essentials for target organs such as the gastrointestinal tract，liver，skin，and kidneys，and elaborates on the application of a nurse-led structured triage process，diagnostic treatment suspension strategies，and electronic patient-reported outcomes in whole-process management. On this basis，the article analyzes the value of the multidisciplinary collaboration model and the construction path of a localized nursing system in China，aiming to provide a reference for enhancing the early risk identification capabilities of oncology specialist nurses and establishing an overlapping toxicity nursing management system suitable for national conditions.

Key words: Immune Checkpoint Inhibitors, Tyrosine Kinase Inhibitors, Overlapping Toxicity, Nursing Assessment, Symptom Management, Oncology Nursing

李晓清. 免疫联合靶向治疗患者重叠毒性护理鉴别及分诊策略的研究进展[J]. 中华护理杂志, 2026, 61(20): 2868-2876.

LI Xiaoqing. Research progress on nursing differentiation and triage strategies for overlapping toxicities in immuno-therapy combined with targeted therapy[J]. Chinese Journal of Nursing, 2026, 61(20): 2868-2876.

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