林敏 张鹏

[摘要] 目的 研究個性化护理对血小板输注治疗患者的护理效果，为患者的护理提供指导。 方法 选取2016年5月～2018年7月在我院进行血小板输注治疗的296例患者进行研究。根据患者入院时的ID尾号，将患者均分为对照组和观察组，各148例。对照组采取常规护理，观察组采取个性化护理。比较两组患者的护理效果、血小板计数变化情况、血小板计数（platelet count，PLT）减少持续时间及不良反应。 结果 观察组总有效率（98.64%）明显高于对照组（87.84%），两组比较有统计学意义（P<0.05）。观察组患者的血小板计数化疗3 d为（21.62±2.10）L、化疗5 d为（73.95±5.86）L、化疗7 d为（112.22±8.65）L明显高于对照组的血小板计数[化疗3 d（15.34±2.08）L、化疗5 d（68.32±6.01）L、化疗7 d（98.10±7.68）L;PLT减少持续时间（4.25±1.75）d明显低于对照组的PLT减少持续时间（7.05±2.25）d，两组比较有统计学意义（P<0.05）。在输注过程中，观察组的不良反应发生率为2.03%明显低于对照组的不良反应发生率（15.54%），两组比较有统计学意义（χ2=16.866，P=0.001）。 结论 个性化护理措施对血小板输注治疗患者的护理效果良好，可有效改善血小板计数变化情况，缩短PLT减少持续时间，降低不良反应发生率，值得临床中推广应用。

[关键词] 血小板;输注;个性化护理;不良反应

[中图分类号] R473.5          [文献标识码] B          [文章编号] 1673-9701（2020）12-0179-03

Study on nursing effect of personalized nursing on patients treated with platelet infusion

LIN Min1   ZHANG Peng2

1.Xiamen Blood Center， Xiamen 361004， China; 2.Zhongshan Hospital Affiliated to Xiamen University， Xiamen  361004， China

[Abstract] Objective To study the nursing effect of personalized nursing on the patients treated with platelet infusion in order to provide guidance for the nursing of patients. Methods A total of 296 patients treated with platelet infusion therapy in our hospital from May 2016 to July 2018 were enrolled. According to the ID tail number of the patient at the time of admission， the patients were divided into the control group and the observation group， with 148 patients in each group. The control group was given conventional nursing and the observation group was given personalized nursing. The nursing effects， platelet count changes， duration of platelet count（PLT） reduction and adverse reactions of the two groups were compared. Results The total effective rate of the observation group（98.64%） was significantly higher than that of the control group（87.84%）， with statistically significant difference between the two groups（P<0.05）. The platelet counts of the observation group were（21.62±2.10） L after chemotherapy for 3 days， （73.95±5.86） L after chemotherapy for 5 days， and（112.22±8.65） L after chemotherapy for 7 days， which were significantly higher than the（15.34±2.08） L， （68.32±6.01） L and（98.10±7.68） L of the control group after chemotherapy for 3， 5 and 7 days. The PLT reduction duration was（4.25±1.75） d， which was significantly shorter than the（7.05±2.25） d of the control group， with statistically significant difference between the two groups（P<0.05）. During the infusion， the incidence of adverse reactions of the observation group（2.03%） was significantly lower than that of the control group（15.54%）， with statistically significant difference between the two groups（χ2=16.866， P=0.001）. Conclusion Personalized nursing measures have a good effect on the patients treated with platelet infusion. It can effectively improve the changes of platelet count， shorten the duration of PLT reduction and reduce the incidence of adverse reactions， thereby worthy of clinical application.

[Key words] Platelets; Infusion; Personalized nursing; Adverse reactions

血小板输注能有效预防与治疗因血小板减少引发的疾病，其是一种非常有效的治疗方法，可降低化疗后血小板减少导致出血的病死率[1]。但是，也有部分患者在血小板输注中发生出血等情况，且未得到改善，其主要是因为免疫因素或其它因素使输入的血小板被破坏，从而使输注效果受損甚至完全无效，被称为“血小板输注无效”[2]。其原因是当患者因妊娠和血小板输注引起异体免疫和致敏，产生血小板所具有抗原的抗体时，这种抗体可破坏输入的具有相应抗原的血小板而使输注无效。目前，研究认为CCI小于7.5～10时可认定为血小板输注无效[3]。近年来，有研究发现，血小板在输注过程中会出现诸多不良反应，若护理不恰当，会严重影响治疗效果。临床多采取常规护理对血小板输注治疗，其有一定的疗效，但存在局限。随着个性化护理逐渐被应用于临床护理中，个性化护理可有效改善血小板计数的变化情况，且副作用很小[4]。……