精细化水化方案对预防异基因造血干细胞移植后并发出血性膀胱炎的研究
收稿日期: 2023-06-16
网络出版日期: 2024-03-18
基金资助
2021年度上海交通大学医学院护理科研项目(Jyhz2104)
Study of a refined hydration programme in preventing hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation
Received date: 2023-06-16
Online published: 2024-03-18
目的:比较3种水化方式对预防异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)后并发出血性膀胱炎(hemorrhagic cystitis,HC)的影响。方法:145例在我院行allo-HSCT的血液病患者随机分为A组(49例)、B组(48例)、C组(48例),A组为常规静脉和口服水化,B组为精细化静脉和口服水化,C组为除必要静脉用药外的精细化口服水化。对3组患者HC发生率、饮水依从性、饮水合格率和护理满意度进行比较。结果:HC发生率B组、C组低于A组(P<0.05),但B组与C组间差异无统计学意义(P>0.05);饮水总依从率B组、C组高于A组(P<0.05);护理满意度B组、C组高于A组(P<0.05)。结论:实施精细化水化方案的2组均可以降低HC发生率,提升患者饮水依从性,提升护理满意度。精细化口服水化更经济、安全,为血液病患者水化治疗的更优选择。
关键词: 出血性膀胱炎; 精细化水化; 水化治疗; 异基因造血干细胞移植
王创琦, 王茜, 王文威, 吴霏霏, 章艳琳 . 精细化水化方案对预防异基因造血干细胞移植后并发出血性膀胱炎的研究[J]. 内科理论与实践, 2023 , 18(06) : 431 -435 . DOI: 10.16138/j.1673-6087.2023.06.010
Objective To compare the effects of three hydration modalities on prevention of concomitant hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods One hundred and forty-five hematologic patients undergoing allo-HSCT in our hospital were randomly divided into group A (49 patients), group B (48 patients) and group C (48 patients), in which group A was treated by the conventional intravenous and oral hydration, group B was treated by the refined intravenous and oral hydration, and the group C received the treatment of refined oral hydration except for necessary intravenous medication. The occurrence of HC, water compliance, water qualification rate and nursing satisfaction were compared among three groups. Results The incidence of HC in groups B and C was lower than that in group A, but the difference between groups B and C was not statistically significant (P>0.05). The total compliance rates of drinking water in the patients of groups B and C were higher than that in group A (P<0.05); the nursing satisfaction of patients in groups B and C was higher than that in group A(P<0.05). Conclusions The refined hydration programmes can reduce the incidence of HC, improve compliance of drinking water and nursing satisfaction in the patient receiving allo-HSCT. The refined oral hydration is safer and more economical, which is a better choice for hydration treatment in the haematological patients.
[1] | 武倩, 周芳, 宋宁霞, 等. 异基因造血干细胞移植后出血性膀胱炎的临床特征及高危因素分析[J]. 中华血液学杂志, 2019, 40(3): 187-190. |
[2] | 杨蕊雪, 陈刚, 玛丽娅·木哈什, 等. 外周血造血干细胞移植后重度难治出血性膀胱炎2例[J]. 疑难病杂志, 2022, 21(3): 304-305. |
[3] | 何云燕. 造血干细胞移植后出血性膀胱炎的诊疗[J]. 临床儿科杂志, 2022, 40(1): 8-13. |
[4] | 郭道远. 造血干细胞移植术后出血性膀胱炎的研究进展[D]. 重庆: 重庆医科大学, 2016. |
[5] | 何洁琳. 造血干细胞移植术后并发出血性膀胱炎的多因素研究[D]. 杭州: 浙江中医药大学, 2017. |
[6] | 李莹, 杨隽, 许晓倩, 等. 异基因造血干细胞移植后出血性膀胱炎发生危险因素分析[J]. 内科理论与实践, 2020, 15(5): 326-331. |
[7] | Atilla E, Ate? C, Uslu A, et al. Prospective analysis of hemorrhagic cystitis and BK viremia in allogeneic hematopoietic stem cell transplantation[J]. Turk J Hae-matol, 2020, 37(3): 186-192. |
[8] | Arango M, Cardona D. Hemorrhagic cystitis after haploidentical transplantation with post-transplantation cyclophosphamide[J]. Biol Blood Marrow Transplant, 2020, 26(8): 1492-1496. |
[9] | Jiang H, Geng L, Wan X, et al. Incidence and risk factors of late-onset hemorrhagic cystitis after single umbilical cord blood transplantation with myeloablative conditioning regimen[J]. Int J Hematol, 2021, 114(3): 381-389. |
[10] | 邓兰兰, 邱坤银, 廖雄宇, 等. 儿童异基因造血干细胞移植术后迟发性出血性膀胱炎的病因学研究[J]. 中国实验血液学杂志, 2018, 26(4): 1167-1173. |
[11] | 张兵, 扈臣媛, 于迪, 等. 影响异基因造血干细胞移植后出血性膀胱炎恢复的多因素分析[J]. 中国实验血液学杂志, 2019, 27(3): 976-982. |
[12] | 舒展, 王悦, 翟所迪. 环磷酰胺致出血性膀胱炎的监测与防治[J]. 药物不良反应杂志, 2006, 8(4): 269-272. |
[13] | 王励, 白献红, 李莉, 等. 异基因造血干细胞移植中出血性膀胱炎的预防及护理[J]. 护士进修杂志, 2006, 21(12): 1146-1147. |
[14] | 刘湘玫, 张春燕, 李杨. 预防环磷酰胺致出血性膀胱炎的临床研究进展[J]. 护理研究, 2013, 27(21): 2189-2190. |
[15] | Yu CY, Lo YH, Chiou WK. The 3D scanner for measuring body surface area: a simplified calculation in the Chinese adult[J]. Appl Ergon, 2003, 34(3): 273-278. |
[16] | 刘国华, 盛迪晔. 基于三维测量的人体表面积计算公式的比较[J]. 解剖学报, 2019, 50(5): 627-632. |
[17] | 朱搏宇, 张晓辉, 张志芳, 等. 造血干细胞移植术后出血性膀胱炎的分级护理[J]. 现代临床护理, 2019, 18(7): 6-10. |
[18] | 黄晓军, 等. 实用造血干细胞移植[M]. 北京: 人民卫生出版社, 2014: 378. |
[19] | 周林, 李华, 张东友. 老年冠心病患者他汀类服药依从性影响因素分析[J]. 中国循证心血管医学杂志, 2017, 9(9): 1118-1120. |
[20] | 潘小容, 莫霖, 黄先巧, 等. 造血干细胞移植并发出血性膀胱炎危险因素的Meta分析[J]. 护理学杂志, 2018, 33(19): 89-94. |
[21] | 熊艺颖, 蔡铎, 陈建斌, 等. 227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析[J]. 第三军医大学学报, 2021, 43(21): 2321-2330. |
[22] | 孙春红, 王晓宁, 罗敏娜, 等. 异基因造血干细胞移植后并发出血性膀胱炎的危险因素分析[J]. 中国实验血液学杂志, 2021, 29(2): 610-614. |
[23] | Hensley ML, Hagerty KL, Kewalramani T, et al. American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants[J]. J Clin Oncol, 2009, 27(1): 127-145. |
[24] | Visintini C, Venturini M, Palese A. Haemorrhagic cystitis, preventive and treatment interventions in patients undergoing haematopoietic stem cell transplantation[J]. Eur J Oncol Nurs, 2019, 42: 50-62. |
[25] | 侯秋秀, 陈惠珍, 林映华. 强化水化/碱化方法预防造血干细胞移植患者急性出血性膀胱炎的护理[J]. 中华现代护理杂志, 2010, 16(9): 1015-1016. |
[26] | 候煜, 杨艳, 张芳, 等. 心理护理对老年患者长时间静脉输液的影响[J]. 中国健康心理学杂志, 2013, 21(3): 405-406. |
[27] | 赵寅, 万阳阳. 系统性护理干预在降低成人急性髓系白血病化疗期间口腔黏膜炎发生率中的应用[J]. 川北医学院学报, 2022, 37(2): 262-265. |
[28] | 赵将, 谢娟, 李旭, 等. 多学科协作下全程管理在肿瘤患者化疗所致恶心呕吐中的应用研究[J]. 护理管理杂志, 2022, 22(3): 220-224. |
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