目的 总结27例多发性骨髓瘤合并肾功能不全患者化疗期间的护理,并对1例临终患者进行安宁疗护的探索.方法 回顾27例多发性骨髓瘤肾病,在入院后骨痛护理、贫血护理、感染护理、透析相关护理以及化疗期间的周围神经病变护理及化疗药物副作用护理,并对1例临终患者进行安宁护理探索.结果 27例患者中5例达完全缓解,14例达部分缓解,5例病情稳定.3例因病情进展死亡,其中药物不良反应主要包括周围神经病变及骨髓抑制.结论 硼替佐咪联合化疗治疗多发性骨髓瘤肾病取得较好疗效,并密切监测药物不良反应;通过适当的临床护理可以改善病情促进患者恢复.%Objective To summarize the nursing care of 27 patients with multiple myeloma complicated with renal insufficiency during chemotherapy,and to explore the hospice care of a patient with dying. Methods Review of 27 cases of myeloma nephropathy in our hospital, post-hospital bone pain care,anemia care,infection care,dialysis-related care,and peripheral neuropathy care and chemotherapy side effects during chemotherapy,and a case of dying care for dying patients explore. Results Of the 27 patients,5 achieved complete remission,14 achieved partial remission and 5 remained stable. 3 cases died of disease progression;among them,adverse drug reactions mainly include peripheral neuropathy and myelosuppression. Conclusion Bortezomib combined with chemotherapy for multiple myeloma nephropathy has achieved good results and closely monitored adverse drug reactions;appropriate clinical care can improve the condition and promote patient recovery.
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