Abstract: Objective To explore the effects of different lengths of supine position after intrathecal chemotherapy on occurrence of complications in children with leukemia,in order to determine an optimum length of supine position for improving comfort. Methods Clinical experimental design was adopted, and children patients were assigned into 3 groups according to the sequence of admission using random table number, including supine position for 2 hours,3 hours,and 4 hours after intrathecal chemotherapy. Complications that occurred during supine position and 1 week after intrathecal chemotherapy were recorded. The level of tolerance and activities during supine position were also recorded. Results Totally 180 children were included in this study with 60 cases in each group. There was no significant difference in the incidence of complications among three groups during supine position and in the following week(P>0.05). Difference in the level of tolerance among groups had significant difference (P<0.05)，and the 2-hour group had the best tolerance. There was no difference in activities during supine position among three groups(P>0.05). More physiological needs were observed for longer length of supine position. Conclusion Two hours for supine position after intrathecal chemotherapy does not increase the incidence of complications in children with leukemia, and the level of tolerance would also be improved, which would be recommended.

Key words: Leukemia, Intrathecal Injection, Complication, Supine Positon, Comfort Degree, Pediatric Nursing

摘要： 目的 探讨白血病患儿鞘内注射后不同去枕平卧时间对并发症发生情况的影响，以确定适宜的术后去枕平卧时间，提高患儿耐受性。方法 2017年6月5日一12月28日，选取北京市某三级甲等儿童专科医院处于维持治疗阶段，需进行鞘内注射的白血病患儿为研究对象，按照患儿入院先后顺序，应用随机数字表将患儿随机分为3组，鞘内注射后分别去枕平卧2h、3h、4h，观察患儿去枕平卧期间及鞘内注射后1周内并发症的发生情况、患儿对去枕平卧体位的耐受程度以及去枕平卧期间患儿的主要活动。结果 共有180例患儿完成研究，每组60例，3组在去枕平卧期间及鞘内注射后1周内并发症发生情况比较，差异无统计学意义(P>0.05);组间去枕平卧体位的耐受性比较，差异具有统计学意义（P<0.05)，去枕平卧2h患儿耐受性最好；3组平卧期间的主要活动比较，差异无统计学意义（P>0.05)，卧床时间越长，患儿生理需求越多。结论 白血病患儿鞘内注射后去枕平卧2h不增加并发症的发生率，且能够提高患儿的耐受性，建议白血病患儿鞘内注射后去枕平卧2h。

关键词: 白血病, 鞘内注射, 并发症, 平卧, 舒适度, 儿科护理学