1例Rh阴性肺癌患者化疗后骨髓抑制护理及分析.docVIP

1例Rh阴性肺癌患者化疗后骨髓抑制的护理及分析 　　[摘要] 对1例Rh阴性肺癌患者化疗后骨髓抑制进行护理及分析。患者以肺部感染收入院经抗生素抗感染治疗效果差，进一步检查诊断为肺腺癌，已无手术指征，行“培美曲塞”单药化疗，化疗后骨髓抑制血小板降至8×109/L，急需输血经化验血型为B型Rh（-），供血源不足不能及时输入同型血，患者病情危重随时可能发生出血的危险，情绪波动较大，为挽救患者生命多次间歇输入B型Rh（+）血小板8 u、B型Rh（-）型血小板3 u护士密切观察患者病情变化，输后无不良反应，体内未产生D抗体，同时加强对患者的健康宣教、心理护理及骨髓抑制的护理，经积极治疗和护理患者病情好转出院。 　　[关键词] 肺癌；化疗；骨髓抑制；输血 　　[中图分类号] R734.2；R473 [文献标识码] B [文章编号] 1673-9701（2017）11-0146-03 　　Nursing and analysis of bone marrow suppression after chemotherapy in 1 case of Rh-negative lung cancer 　　ZHANG Sumei1 ZHU Bin2 　　1.Department of Respiratory，Zibo City Central Hospital in Shandong Province，Zibo 255036，China；2.Department of Laboratory，Zibo City Central Hospital in Shandong Province，Zibo 255036，China 　　[Abstract] To nurse and analyze the bone marrow suppression after chemotherapy in 1 patient with Rh-negative lung cancer. The patient with lung infection was admitted in our hospital， and the antibiotic treatment of anti-infective effect was poor for the patient. The patient had no indications for surgery when diagnosed with lung adenocarcinoma after further examination，and was given single drug chemotherapypemetrexed. And the bone marrow was suppressed after chemotherapy with platelet down to 8×109/L. The patient needed for blood transfusion urgently，whose blood type was type B Rh（-） by the blood test. The supply of blood was insufficient and the same type of blood could not be timely transfused. Patients in critical condition might have the risk of bleeding at any time，with great fluctuating mood. 8 u of type B Rh（+） platelets and 3 u of type B RH（-） were intermittently transfused multiply to save the patient life. The nurse observed the patients condition closely. No adverse reactions occurred after transfusion， and the body did not produce D antibodies. Meanwhile， the health education of patients， psychological care and care of bone marrow suppression were strengthened. The patient was discharged with the condition improved after the active treatment and c