THE NURSING OF THE
PATIENTS WITH ALL USING HIGH-DOSE MTX THERAPY
Liu J,
Deng ZY
Chongqing
Children's Hospital, Chongqing, China
Objective: Observe the effect and toxicity
of high-dose MTX (HDMTX) on the patients with acute lymphoblastic leukemia
(ALL) and take the corresponding nursing measures to assure the
chemotherapy be carried out as planned.
Methods: For the 8 patients with All in
complete remission, MTX in 3g/m2, q14d x 3 times and the
corresponding treatments were given to prevent the ALL occurred outside the
bone marrow. During this period the major nursing measures taken included
psychological care, rest and nutrition, strict sterilization of the patient
room and the intensive care for the skin, mucosa, gastrointestin and the
vein for venoclysis.
Results: For the 8 patients, the bone marrow depression
happened 18 times and the infections were found in 3 patients including the
two with upper respiratory infections and the one with septicemia. The
infections were controlled soon after using antibiotics. There were four
patients having the level of ALT and AST increased. The nausea and vomiting
happened in two patients, mouth ulcer was seen in one patients and the
enzymes for cardiomyo was abnormal in one patients.
Conclusions: The strict sterilization and
intensive care for the skin, mucosa, gastroinstestin and the vein plus
adequate fluid and alkalinize will be able to reduce the toxicity of HDMTX
and assure the chemotherapy be carried out as planned.