甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制的护理研究(1)
【摘要】 目的：探讨甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制的护理。方法：随机选取2016年3月-2018年6月本院收治的甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制患者40例作为研究对象，依据不同的护理方法将其分为常规组和综合组，每组20例。常规组接受常规护理，综合组接受综合护理，比较分析两组的临床疗效、不良反应发生及死亡情况。结果：综合组总有效率为95.0%(19/20)明显高于常规组的70.0%(14/20)，两组比较差异有统计学意义(字2=14.45，P<0.05)。综合组不良反应发生率、死亡率分别为5.0%(1/20)和0均明显低于常规组的30.0%(6/20)及20.0%(4/20)，两组比较差异均有统计学意义(字2=14.45、4.44，P<0.05)。结论：甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制的综合护理较常规护理更能有效提升患者护理的总有效率，降低患者不良反应发生率和死亡率。
【关键词】 甲氨蝶呤； 类风湿性关节炎； 骨髓抑制； 护理
【Abstract】 Objective：To explore the nursing of Methotrexate in the treatment of bone marrow suppression caused by rheumatoid arthritis.Method：A total of 40 patients with bone marrow suppression caused by rheumatoid arthritis treated with Methotrexate admitted in our hospital from March 2016 to June 2018 were randomly selected as the study objects.According to different nursing methods，they were divided into conventional group and comprehensive group，20 cases in each group.The conventional group was received routine nursing，the comprehensive group was received comprehensive nursing.The clinical efficacy，adverse reactions and death between the two groups were compared and analyzed.Result：The total effective rate of the comprehensive group was 95.0% (19/20)，which was higher than 70.0% (14/20) of the conventional group，the difference was statistically significant (字2=14.45，P<0.05).The incidence of adverse reactions and mortality in the comprehensive group were 5.0% (1/20) and 0 respectively，which were significantly lower than 30.0% (6/20) and 20.0% (4/20) in the conventional group，the differences were statistically significant (字2=14.45，4.44；P<0.05).Conclusion：Comprehensive nursing of Methotrexate in the treatment of bone marrow suppression caused by rheumatoid arthritis can effectively improve the total effective rate，reduce the incidence of adverse reactions and mortality of patients.
【Key words】 Methotrexate； Rheumatoid arthritis； Bone marrow suppression； Nursing
First-author’s address：Pingxiang People’s Hospital，Pingxiang 337000，China
doi：10.3969/j.issn.1674-4985.2018.31.016
甲氨蝶呤屬于一种慢作用抗风湿药，近年来，在类风湿性关节炎的治疗中，其已经成为临床的首选药物，主要不良反应为血液系统受累，贫血、粒细胞减少等，也是其主要临床表现，一些情况下还会有重度骨髓抑制发生，严重的情况下还会造成患者死亡[1]。本研究比较了甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制的常规护理与综合护理的效果，现报道如下。
1 资料与方法
1.1 一般资料 随机选取2016年3月-2018年
6月本院收治的甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制患者40例作为研究对象，纳入标准：均符合类风湿性关节炎的诊断标准[2]；均经临床症状及实验室检查确诊为类风湿性关节炎；均有一定程度的关节功能改变。排除标准：甲氨蝶呤禁忌证；未发生骨髓抑制。依据不同的护理方法将其分为常规组和综合组，每组20例。所有患者均知晓本次研究并签署知情同意书，该研究已经医院伦理学委员会批准。
1.2 方法 常规组患者接受常规护理，在接受治疗发生骨髓抑制后遵医嘱让患者服用科学合理药物，并对其进行个体化的护理，从而对骨髓抑制进行有效控制。综合组患者接受综合护理，骨髓抑制的护理具体操作如下。, http://www.100md.com(叶串连)
【关键词】 甲氨蝶呤； 类风湿性关节炎； 骨髓抑制； 护理
【Abstract】 Objective：To explore the nursing of Methotrexate in the treatment of bone marrow suppression caused by rheumatoid arthritis.Method：A total of 40 patients with bone marrow suppression caused by rheumatoid arthritis treated with Methotrexate admitted in our hospital from March 2016 to June 2018 were randomly selected as the study objects.According to different nursing methods，they were divided into conventional group and comprehensive group，20 cases in each group.The conventional group was received routine nursing，the comprehensive group was received comprehensive nursing.The clinical efficacy，adverse reactions and death between the two groups were compared and analyzed.Result：The total effective rate of the comprehensive group was 95.0% (19/20)，which was higher than 70.0% (14/20) of the conventional group，the difference was statistically significant (字2=14.45，P<0.05).The incidence of adverse reactions and mortality in the comprehensive group were 5.0% (1/20) and 0 respectively，which were significantly lower than 30.0% (6/20) and 20.0% (4/20) in the conventional group，the differences were statistically significant (字2=14.45，4.44；P<0.05).Conclusion：Comprehensive nursing of Methotrexate in the treatment of bone marrow suppression caused by rheumatoid arthritis can effectively improve the total effective rate，reduce the incidence of adverse reactions and mortality of patients.
【Key words】 Methotrexate； Rheumatoid arthritis； Bone marrow suppression； Nursing
First-author’s address：Pingxiang People’s Hospital，Pingxiang 337000，China
doi：10.3969/j.issn.1674-4985.2018.31.016
甲氨蝶呤屬于一种慢作用抗风湿药，近年来，在类风湿性关节炎的治疗中，其已经成为临床的首选药物，主要不良反应为血液系统受累，贫血、粒细胞减少等，也是其主要临床表现，一些情况下还会有重度骨髓抑制发生，严重的情况下还会造成患者死亡[1]。本研究比较了甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制的常规护理与综合护理的效果，现报道如下。
1 资料与方法
1.1 一般资料 随机选取2016年3月-2018年
6月本院收治的甲氨蝶呤治疗类风湿性关节炎导致骨髓抑制患者40例作为研究对象，纳入标准：均符合类风湿性关节炎的诊断标准[2]；均经临床症状及实验室检查确诊为类风湿性关节炎；均有一定程度的关节功能改变。排除标准：甲氨蝶呤禁忌证；未发生骨髓抑制。依据不同的护理方法将其分为常规组和综合组，每组20例。所有患者均知晓本次研究并签署知情同意书，该研究已经医院伦理学委员会批准。
1.2 方法 常规组患者接受常规护理，在接受治疗发生骨髓抑制后遵医嘱让患者服用科学合理药物，并对其进行个体化的护理，从而对骨髓抑制进行有效控制。综合组患者接受综合护理，骨髓抑制的护理具体操作如下。, http://www.100md.com(叶串连)