Abstract:

To summarize rescuing and nursing experience of 3 ectopic pregnancy patients，suffering from severe toxicity caused by low-dose methotrexate（MTX） treatment. The key points include：constantly monitoring of patients for at least a week after MTX administration，and identifying MTX toxicity related symptoms as soon as possible；promptly establishing a multidisciplinary medical team to establish individualized rescue plans；quickly initiating the rescue therapy and implementing targeted fluid management to accelerate MTX excretion；intensifying protective isolation caring to prevent and control infection；applying refined safety management to prevent spontaneous bleeding；providing intensive caring of skin and mucosal toxicity symptoms to promote healing process；supplying individualized psychological counseling and support in time；strengthening the protection of the damaged organ. After emergent rescuing and intensive nursing，all 3 patients successfully recovered and were discharged from the hospital.

Key words: Methotrexate, Ectopic Pregnancy, Myelosuppression, Toxicity Reaction, Obstetrical Nursing

摘要：

总结3例小剂量甲氨蝶呤治疗异位妊娠致严重毒性反应的解救和护理经验。护理要点：加强病情观察，尽早识别小剂量甲氨蝶呤严重毒性反应；组建多学科医护团队，制订个体化解救方案；快速启动解救治疗，实施目标导向液体管理，促进药物排泄；加强保护性隔离集束化护理，实施精细化安全管理，积极预防感染及自发性出血；加强皮肤黏膜毒性症状护理，促进皮肤黏膜愈合；进行个体化心理护理，及时提供心理支持；加强受损器官功能保护。经过紧急的解救和精准护理，3例患者均康复出院。

关键词: 甲氨蝶呤, 异位妊娠, 骨髓抑制, 毒性反应, 产科护理