【摘要】 目的：探究感恩情绪护理对多发性骨髓瘤患者行血浆置换效果的影响。方法：选取2012年4月-2015年6月于本院接受治疗的86例多发性骨髓瘤患者为研究对象。按照随机数表法将86例患者分为试验组和对照组，每组各43例患者。两组均实施血浆置换，对照组行常规护理，试验组在此基础上加以感恩情绪护理。比较两组患者治疗前后贫血缓解时间、溶血缓解时间；比较两组患者接受治疗5、10 d后血小板、血浆D-二聚体水平；比较治疗10 d后甲状腺球蛋白（TG）、肿瘤坏死因子-（TNF-）、白细胞介素-6（IL-6）的水平变化情况；治疗4 d后对两组患者进行急性生理和慢性健康状况评价（APACHE），比较两组患者评分情况。结果：试验组患者贫血缓解时间为（3.541.12）d、溶血缓解时间为（5.071.52）d，均少于对照组的（6.171.24）、（9.651.62）d，比较差异均有统计学意义（P0.05）；治疗5、10 d后，试验组血小板水平分别为（34.5712.14）、（78.8415.06）109/L，血浆D-二聚体水平分别为（207.5117.82）、（163.3915.47）g/L，与对照组比较差异均有统计学意义（P0.05）；治疗10 d后，试验组TG水平为（1.921.07）mmol/L，TNF-水平为（5.723.67）pg/mL，IL-6水平为（16.324.08）pg/mL，与对照组比较差异均有统计学意义（P0.05）；试验组治疗4 d后APACHE评分为（6.731.76）分，对照组为（9.512.92）分，比较差异有统计学意义（P0.05）。
结论：感恩情绪护理对于多发性骨髓瘤患者行血浆置换有促进效果，能够加快患者行血浆置换后的身体恢复，值得广泛推广
【关键词】 感恩情绪护理； 多发性骨髓瘤； 血浆置换
Impact of Thanksgiving Emotion Nursing on Patients Multiple Myeloma Plasma Exchange/ZHANG Bi-xia，GUO Zhi-qiang，ZHAI Ying-jun，et al.//Medical Innovation of China，2016，13（20）：086-089
【Abstract】 Objective：To explore the effects of thanksgiving emotion care of patients with multiple myeloma plasma exchange.Method：A total of 86 cases of multiple myeloma treated in our hospital were chosen from April 2012 to June 2015.According to the random number table，the patients were randomly divided into experimental group and control group， 43 patients in each group.The two groups were all implemented plasma exchange，the control group received routine care，the experimental group on this basis to be grateful emotional care.Two groups of patients before and after the treatment of anemia remission time，hemolytic remission time were compared.5 days and 10 days after treatment，the plasma D-two polymer，thyroid globulin TG，tumor necrosis factor-（TNF-），the level of interleukin-6（IL-6） levels were compared between two groups of patients.Acute physiology and chronic health evaluation （APACHE） were performed in two groups after 4 days of treatment，and the scores of two groups were compared.Result：The experimental groups anemia dissolution time was （3.541.12）days，hemolysis remission time was（5.071.52）days were less than control groups （6.171.24），（9.651.62）days，the results were different（P0.05）. After treatment for 5，10 days，platelet levels were （34.5712.14），（78.8415.06）109/L，plasma D-dimer level were （207.5117.82），（163.3915.47）g/L of the experimental group，compared with the control group，the results were different（P0.05）.After treatment for 10 days，TG levels was（1.921.07）mmol/L，TNF- level was （5.723.67）pg/mL，IL-6 levels was （16.324.08）pg/mL，compared with the control group，the results were different（P0.05）. After treatment for 4 days，APACHE score of the experimental group was （6.731.76）scores，the control group was （9.512.92）scores，the results had differences（P0.05）.Conclusion：Thanksgiving emotional care for patients with multiple myeloma plasma exchange has the effect of promoting，speeding up the recovery of patients undergoing plasma exchange，it should be popularized. 【Key words】 Thanksgiving emotion care； Multiple myeloma； Plasma exchange
First-authors address：Yue Bei Peoples Hospital，Shaoguan 512026，China
doi：10.3969/j.issn.1674-4985.2016.20.023
多发性骨髓瘤（MM）是一种常见的血液疾病，是由于浆细胞恶性增生产生恶性肿瘤，恶化的浆细胞分泌大量的单克隆免疫球蛋白，临床上通常会引起各种高黏滞综合征（HVS），临床上常伴有严重感染和肾功能损害[1-2]。MM主要有以下临床特征：溶骨性损害、血小板减少、微血管病性溶血性贫血、神经系统受损、发热以及肾功能损害，74%以上的患者主要变现为MM四联征（溶骨性损害、血小板减少、微血管病性溶血性贫血、神经系统受损），40%～73%的患者表现为六联征[3-4]。血浆置换（PE）治疗MM是国内新近开展的技术，PE已成为临床上治疗多种疑难重症疾病的有效手段，本院在此基础上进行有关感恩情绪护理对于血浆置换效果的影响研究。。
1 资料与方法
1.1 一般资料 选取2012年4月-2015年6月于本院接受治疗的86例多发性骨髓瘤（MM）患者为研究对象，其中男37例，女49例，平均年龄（538）岁。所有患者均符合《血液病诊断及疗效标准》中有关MM的诊断标准[5]，其中四联症患者63例，六联症患者23例。纳入标准：（1）无精神病史；（2）无语言功能障碍，能正常交流沟通；（3）家属及本
发表于 2018-8-18 20:50:50