摘要
目的探讨集束化护理降低急性白血病患者化学治疗(化疗)期间肺部感染发病率的效果。方法采用类试验研究设计,以2019年8月—2021年12月某三级甲等医院血液内科收治的急性白血病患者为研究对象,A病区为对照组,B病区为干预组,干预组与对照组依据白血病类型及年龄(±5岁)进行配对。干预组采取集束化护理干预措施,包括护士主导的系统性健康教育、减少暴露、强化口腔护理和呼吸训练器驱动的肺功能锻炼;对照组采取常规措施,连续观察2个化疗疗程,分析比较两组患者肺部感染发病率、肺部感染类型和肺功能[第1秒用力呼气量占预测值百分比(FEV1%)值]的差异。结果第1个化疗周期两组实际匹配47对患者;第2个化疗周期最终完成34对患者的匹配。干预组和对照组患者肺部感染发病率分别为35.80%、43.21%,差异无统计学意义(P>0.05);干预组患者侵袭性肺部真菌感染发病率为3.70%,对照组为12.35%,差异具有统计学意义(P<0.05);重复测量方差分析显示干预组患者肺功能FEV1%值优于对照组(P<0.05);干预组患者口腔黏膜炎发病率为11.11%,低于对照组的24.69%,差异有统计学意义(P<0.05)。结论集束化护理能有效降低患者肺部真菌感染发病率和改善患者肺功能,同时预防口腔黏膜炎的发生,但降低其它类型肺部感染发病率的效果需进一步探讨。
Objective To explore the effect of bundled care on reducing the incidence of pulmonary infection(PI)in patients with acute leukemia receiving chemotherapy.Methods Quasi-experimental research design was adopted,and patients with acute leukemia in the department of hematology in a tertiary first-class hospital from August 2019 to December 2021 were chosen as the study subjects.Ward A was the control group,and Ward B was the intervention group.The intervention group and the control group were matched based on the type of leukemia and age(±5 years).The intervention group received bundled care intervention measures,including systematic health education led by nurses,reducing exposure,enhancing oral care,and pulmonary function exercises driven by respiration trai-ning device.The control group received routine measures.Two groups were continuously observed for two chemotherapy courses,and the differences in PI rates,PI types,and pulmonary function(the percentage of forced expiratory volume in one second[FEV1%])between two groups of patients were analyzed and compared.Results In the first chemotherapy course,47 pairs of patients from two groups were matched,and 34 pairs of patients ultimately matched in the second chemotherapy course.Incidence of PI in patients in the intervention group and the control group were 35.80%and 43.21%,respectively,with no statistically significant difference(P>0.05).The incidence of invasive pulmonary fungal infections was 3.70%in patients in the intervention group and 12.35%in the control group,with a statistically significant difference(P<0.05).Repeated measures analysis of variance showed that the FEV1%value in patients in the intervention group was better than that in the control group(P<0.05).The incidence of oral mucositis in patients in the intervention group was 11.11%,which was statistically lower than 24.69%in the control group(P<0.05).Conclusion Bundled care can effectively reduce the incidence of pulmonary fungal infections in patients and improve patients’pulmonary function,wh
作者
杨书环
杨贵芳
田桂荣
裴玉燕
董巧凤
夏天
YANG Shu-huan;YANG Gui-fang;TIAN Gui-rong;PEI Yu-yan;DONG Qiao-feng;XIA Tian(Department of Hematology,Heze Municipal Hospital of Shandong Province,Heze 274031,China;Department of Science and Education,Heze Municipal Hospital of Shandong Province,Heze 274031,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2023年第4期435-441,共7页
Chinese Journal of Infection Control
基金
山东省医药卫生科技发展计划项目(2019WS53)
菏泽市立医院科技发展计划项目(2019YN62)。
关键词
集束化护理
急性白血病
肺部感染
化疗
bundled care
acute leukemia
pulmonary infection
chemotherapy
