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急性白血病并发自发性脾破裂护理一例

经外周静脉置入中心静脉导管术与锁骨下静脉插管在造血干细胞移植治疗中的应用效果

目的　探讨经外周静脉置入中心静脉导管（PICC)术在造血干细胞移植患者中的应用。 方法　将2008年2月－2011年6月入住我院并接受造血干细胞移植的95例患者按自愿选择原则，49例纳入观察组采用PICC置管，46例纳入对照组采用锁骨下静脉置管，比较两组静脉穿刺置管时间、一次置管成功率、静脉置管的液体流速及并发症发生情况。 结果　穿刺置管时间观察组平均为16 min，对照组平均为24 min，两组比较差异有统计学意义（P＜0.05）；观察组一次置管成功率97.91%，对照组一次置管成功率82.60%，两组比较差异有统计学意义（P＜0.05）；观察组静脉置管液体流速最大（118 ± 1）滴/min，对照组则为（184 ± 1）滴/min，两组比较差异有统计学意义（P＜0.05）；观察组并发症发生率低，但两组比较差异无统计学意义。 结论　PICC静脉穿刺置管时间短，一次穿刺成功率高，并发症发生率低，静脉液体流速完全能满足治疗需要，值得在造血干细胞移植治疗中推广应用。

Daily nursing for multiple myeloma: whole life cycle health management based on the doctor-nurse-patient integration model

With the continuous development of new drugs and immunotherapy, the survival period of patient with multiple myeloma (MM) is continuously prolonged, and the disease is becoming chronic. Due to the involvement of multiple systems and numerous complications, the daily nursing for MM faces significant challenges. The doctor-nurse-patient integration model and the whole life cycle health management model for daily nursing of MM are expected to reduce the social burden related to diseases, improve patients’ quality of life, and reduce medical costs. This article provides a review on three aspects of MM doctor-nurse-patient integration, whole life cycle health management, and daily health management involving multiple systems.