cases of postoperative chemotherapy in patients with malignant bone tumors Nursing_9063.doc

58 cases of postoperative chemotherapy in patients with malignant bone tumors Nursing标签:作者标签:来源标签:时间 Keywords: bone tumor; chemotherapy; Care Bone tissue or bone tumor is a subsidiary body of the new biology, with primary and metastatic divided. According to their degree of malignancy was divided into benign, malignant, and between benign and malignant giant cell tumor of bone between the 1. For malignant bone tumor is the main treatment for amputees, amputation, after giving security, standardization, and sufficient, full of chemotherapy to kill tumor cells, the maximum saving lives of patients. Chemotherapy is the treatment of malignant bone tumor in a very important part of a stage timely and effective chemotherapy, in improving the survival rate of patients to prevent organ metastasis, the process of saving lives of patients has a huge positive effect. our department in cooperation with each other healthcare workers, 58 patients with malignant bone tumor with chemotherapy and intensive care patients and achieved satisfactory results, now nursing reported as follows. 1 Clinical data Jan. 2004 May 2009 our department treated 58 cases of bone tumor patients, 39 males and 19 females, aged from 15 to 43 years, of which 23 cases of osteosarcoma, Ewings tumor in 14 cases, 13 cases of malignant giant cell tumor , 8 cases of fibrosarcoma of bone. patients on admission showed a huge mass for the local, accompanied by pain in 52 cases, not accompanied by pain in 6 cases, the examination showed no abnormal organ function returns, no organ metastasis. pathologic Return diagnosed as malignant bone tumor, the routine, adequate, accurate, periodic chemotherapy treatment. followed up for 5 months to 5 years, all survived with no visceral metastases. 2 Preparing for chemotherapy Before chemotherapy for malignant bone tumors is very important, including the measurement of vital signs, because most of chemotherapy drugs is based on body weight, and should be strictly accurate measurement of weight, to patients and their families that chemotherapy toxicity may occur, such as gastrointestinal reactions , oral ulcers, hair loss, leukopenia, and so on. These are the chemotherapy that may arise during the case, the symptoms will disappear after the cessation of chemotherapy, reducing the concerns of patients and their families, and help doctors to sign consent of chemotherapy. Chemotherapy of primary care 3 3.1 diet care of patients before chemotherapy to strengthen food, giving high-protein, high calorie, high vitamin light digestible food, do not eat sweet and fried foods, eat more fruits and vegetables, lean meat. Enhance the body resistance and, if necessary lost when the plasma, increase tolerance, to ensure the smooth progress of chemotherapy. daily volume of 3000ml or more water can reduce the renal toxicity, prevention of cystitis. 3.2 Mental Care (1) psychological counseling. By master patients age, educational level, family situation were analyzed. Select the appropriate conversations to explain the disease-related knowledge, of successful treatment of cases, eliminate the pessimism of patients, lifting the burden of thinking , to face reality and actively cooperate with medical treatment. (2) meet the reasonable needs of patients. cancer patients are psychologically vulnerable patients should be regularly inspected, more attention to encourage the patients. patience to listen to tell patients, and patient and friendly conversation, asked patients feelings and needs, to allow family members to accompany patients to comfort, attention to patient desires, is the best psychological support to patients, to do when speaking of the operation and to protect the privacy and dignity of patients. patients with despair or suicide, the concern should be given to prevent accidents. (3) for patients with their loved ones. cancer patients after amputation are afraid of being abandoned by their families, hoping to family members, relatives and friends of the care and comfort, they should approach the treatment of patients and family members the purpose and the mental patients circumstances, to obtain their cooperation. 3.3 puncture site care chemotherapy drugs have a strong irritant, from the leaking blood vessels, can cause local swelling, tenderness, can cause severe local necrosis and ulceration, should take appropriate measures: (1) nursing puncture technique, skilled personnel, poor vascular patients experienced nurses arranged puncture, time and ward visits to observe the puncture site, timely detection of problems and treatment. (2) were planned to protect the blood vessels, select the blood vessel elasticity good, easy fixed, coarse, straight veins. replacement puncture site, to avoid repeated needle into the same site. (3) opening of the first intravenous access with normal saline infusion after chemotherapy, after chemotherapy, 20 30ml saline drip after needle injection, so as to avoid chemotherapy extravasation injury of blood vessels. (4) the use of chemotherapy among more than two bottles of liquid separated from other applications to protect the blood vessels, reduce the patients adverse reaction. (5) intravenous chemotherapy drug use, if drug discovery leakage or local burning sensation, should be discontinued immediately, keep the needle, then under strict aseptic Withdrawing 20ml syringe after needle injection, and local ice 24h, reduced the number and spread of drug extravasation. so that local vasoconstriction. Local obvious swelling, redness in the skin within 24h with 0.25% procaine closed treatment. 3.4 Enter the chemotherapy drugs and nursing observation during infusion of extreme weight loss, weakness, poor patients undergoing cardiopulmonary ECG, if necessary, to give low-flow oxygen inhalation, and drug use based on notes and adjust the infusion rate of the patient. 30 drops / min is appropriate, close observation of vital signs, abnormal timely treatment. Links to Research Papers Download http:/ 4 observation of adverse reactions and complications of treatment 4.1 Prevention of chemotherapy in patients with gastrointestinal reactions in varying degrees of gastrointestinal reactions, our department before chemotherapy and after chemotherapy 30min 30min bolus ondansetron 8mg, antiemetic effect of satisfaction, diet should be light, small meals often . semi-supine feeding, training and deep breathing in patients with the Church scattered method of nausea, such as listening to music, watching television. 4.2 out of observation of the amount recorded during chemotherapy in patients with intake and output, observe the color of vomit, the amount of urine output remained at 3000ml / d or more, to keep out the amount of balance, to prevent electrolyte imbalance. 4.3 mucous membrane, skin reactions, chemotherapy drugs often cause patients varying degrees of oral ulcers, if the disease population, there are dental caries, dentures or leftover food remnants, it is easy to expose the mucosa caused by infection, the formation of oral ulcers should be strengthened oral hygiene, brush your teeth thoroughly, action should be gentle, daily morning and evening, and brushing after meals, gargle, gargle every 2h nitrofurazone, that have occurred in patients with oral ulcers, can be coated Bingpeng San ulcer drugs, there are satisfactory results. 4.4 Observation of blood chemotherapy drugs suppress blood cells, white blood cells and thrombocytopenia many see, therefore, should check blood for blood once every other day, strict aseptic technique. WBC 4 ? 109 / L, platelets 80 ? 109 / L suspended when the chemotherapy, and give rise to reduce white blood cells or the appropriate chemotherapy drugs, patients live in isolation wards, strengthen disinfection, reducing visits, close monitoring of body temperature, keep warm and prevent the decline in immunity to secondary infection, chemotherapy patients in our department had no s