多发免疫相关不良反应伴导管相关性血流感染与血栓形成1例患者的护理体会

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Abstract To summarize the nursing experience of a lung cancer patient with severe rash,heart failure and other immune-related adverse events after treatment with immune checkpoint inhibitors,as well as port catheter-related bloodstream infection and thrombosis.Immediately after the patient is admitted to the hospital,the multidisciplinary team cooperates to quickly identify the source of infection,control systemic and local infection,pay attention to rash changes and strengthen skin care,and the specialist nurse in intravenous therapy is responsible for the maintenance and removal of the implanted venous infusion port,while strictly controlling access volume,maintain negative fluid balance,and maintain effective circulating blood volume.After 21 days of multidisciplinary team treatment,the implanted venous infusion port was removed,the systemic and local infection was controlled,the vital signs were stable,the rash subsided,and there was no abnormality in the follow-up for 30 days after discharge.Rapid identification of the cause,control of infection,maintenance of negative fluid balance,and enhanced skin care through a multidisciplinary team are effective measures to treat and care for such multiple immune-related adverse reactions with catheter-related bloodstream infection and thrombosis.

Key words： Immune-related adverse events Catheter-related bloodstream infection Catheter-related thrombosis Nursing Lung cancer

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I28/167

[1]	Arnold M，Rutherford MJ，Bardot A，et al.Progress in cancer survival，mortality，and incidence in seven high-income countries 1995-2014 （ICBP SURVMARK-2）：a populationbased study[J].Lancet Oncol，2019，20（11）：1493-1505.
[2]	Bray F，Ferlay J，Soerjomataram I，et al.Global cancer statistics 2018：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin，2018，68（6）：394-424.
[3]	Han Y，Wang J，Xu B.Cutaneous adverse events associated with immune checkpoint blockade：A systematic review and meta-analysis[J].Crit Rev Oncol Hematol，2021，163：103376.
[4]	Berti A，Bortolotti R，Dipasquale M，et al.Meta-analysis of immune-related adverse events in phase 3 clinical trials assessing immune checkpoint inhibitors for lung cancer[J].Crit Rev Oncol Hematol，2021，162：103351.
[5]	Zheng X，Wei H.Organ-Specific Immune-Related Adverse Events for PD-1 Antibodies in Lung Cancer Treatment[J].Front Oncol，2021，11：628243.
[6]	Karam JD，Noel N，Voisin AL，et al.Infectious complications in patients treated with immune checkpoint inhibitors[J].Eur J Cancer，2020，141：137-142.
[7]	Nicholson J.Royal College of Nursing's Standards for Infusion Therapy：an overview[J].Br J Nurs，2018，27（2）：S12-S14.
[8]	张海军，邹英华.多普勒超声腔内心电一体化引导建立和维护心血管通路专家共识[J].中国介入影像与治疗学，2020，17（4）：193-197.
[9]	仇晓霞，金光鑫，郭艳，等.肿瘤患者上臂植入输液港并发上肢静脉血栓发生率及危险因素[J].介入放射学杂志，2019，28（3）：242-246.
[10]	Ramos-Casals M，Brahmer JR，Callahan MK，et al.Immunerelated adverse events of checkpoint inhibitors[J].Nat Rev Dis Primers，2020，6（1）：38.
[11]	钟南山.抗菌药物临床应用指导原则（2015年版）[EB/OL].[2021 -06 -13].http：//www.nhc.gov.cn/ewebeditor/uploadfile/2015/09/20150928170007470.pdf.
[12]	王敏芳，干铁儿，丁黎敏，等.多重耐药菌感染综合防控措施的闭环管理及其效果评价[J].中华医院感染学杂志，2021，31（18）：2850-2854.
[13]	Infusion Nurses Society.Infusion Nursing Standards of Practices[J].J Infus Nurs，2006，29（1 Suppl）：S1-92.
[14]	李艳，李婷，伟珍，等.恶性肿瘤患者放化疗期间PICC 导管血流感染的临床特点及预防对策[J].中华医院感染学杂志，2019，29（6）：872-875.
[15]	郭苗苗，陈雁，叶红芳，等.肿瘤日间化疗患者静脉血栓栓塞症预防和管理的证据总结[J].中国护理管理，2020，20（5）：730-734.
[16]	郭婷，熊晓云，孙兴兰，等.慢性心力衰竭病人容量管理的最佳证据应用[J].全科护理，2021，19（27）：3749-3753.
[17]	Slivnick J，Lampert BC.Hypertension and Heart Failure[J].Heart Fail Clin，2019，15（4）：531-541.
[18]	Arrigo M，Jessup M，Mullens W，et al.Acute heart failure[J].Nat Rev Dis Primers，2020，6（1）：16.
[19]	刘晓晴，蒋琪霞，宋思平.皮肤清洗对术后切口感染影响的病例对照研究[J].中西医结合护理（中英文），2020，6（10）：216-218.
[20]	刘晓晴，蒋琪霞，宋思平.伤口患者皮肤清洗研究进展[J].中西医结合护理（中英文），2020，6（8）：295-299.
[21]	纪敬斌，张宸瑜，彭垒，等.非小细胞肺癌新辅助免疫治疗的研究进展、获益人群、治疗周期和疗效预测[J].中国肺癌杂志，2022，25（2）：92-101.
[22]	Moslehi JJ，Salem JE，Sosman JA，et al.Increased reporting of fatal immune checkpoint inhibitor-associated myocarditis[J].Lancet，2018，391（10124）：933.
[23]	蒋爱民，马宇彦，刘娜，等.肺癌患者院内感染微生物学特点及预后因素分析[J].现代肿瘤医学，2022，30（9）：1598-1602.
[24]	唐淑慧，侯黎莉，王汇.非小细胞肺癌患者免疫治疗致皮肤毒性的调查研究[J].护理学杂志，2020，35（16）：35-37.
[25]	杨艳利，宁亮，宋宝美.特瑞普利单抗治疗相关性皮肤不良反应的护理[J].中西医结合护理（中英文），2020，6（6）：137-139.