1例肺癌患者行信迪利单抗联合化疗并发免疫相关性结肠炎的护理-临床护理进展.pdf

1例肺癌患者行信迪利单抗联合化疗并发免疫相关性结肠炎的护理

【摘要】肿瘤免疫治疗的治疗效果显著，但引发的相关并发症对恢复造成不良影响，导致预后不佳。目前尚

未有关于免疫相关性结肠炎的护理指南，故本研究总结1例晚期肺癌患者行信迪利单抗联合吉西他滨治疗4个周

期后出现免疫相关性结肠炎的护理体会，在初期做到早识别、早治疗及早护理，从而控制病情改善预后，以期为

后续类似病例的护理提供借鉴。护理要点是可冲洗排泄物管理套件低负压吸引的皮肤管理，以免疫营养素为主的

分阶段营养干预，改良式灌肠器保留中药灌肠护理。13天后患者症状好转并顺利出院，1个月后随访，复查肠

镜无异常后继续行抗肿瘤治疗。

【关键词】PD-1抑制剂；信迪利单抗；免疫相关性结肠炎；肺癌；护理

【收稿日期】2024年8月16日【出刊日期】2024年9月29日【DOI】10.12208/j.jacn

Nursingcareofapatientwithlungcancerreceivingsindilizumabcombinedwithchemotherapycomplicated

withimmune-associatedcolitis

【Abstract】Thetherapeuticeffectoftumorimmunotherapyisremarkable,buttherelatedcomplicationscauseadverse

effectsonrecoveryandleadtopoorprognosis.Atpresent,therearenonursingguidelinesonimmune-associatedcolitis.

Therefore,thisstudysummarizedthenursingexperienceofapatientwithadvancedlungcancerwhodevelopedimmune-

associatedcolitisafter4cyclesoftreatmentwithsindellizumabcombinedwithgemcitabine,andachievedearly

identification,earlytreatmentandearlynursingattheearlystage,soastocontrolthediseaseandimprovetheprognosis,

hopingtoprovidereferenceforthefollow-upnursingofsimilarcases.Thekeypointsofcareareflushableexcreta

managementkit,skinmanagementwithlownegativepressureattraction,phasednutritioninterventionbasedonimmune

nutrients,andimprovedenemaretentionofChinesemedicineenemacare.After13days,thepatientssymptomsimproved

andhewasdischargedsuccessfully.Afterafollow-upvisitonemonthlater,noabnormalitywasfoundinthecolonoscopy

andantitumortherapywascontinued.

【Keywords】PD-1inhibitor;Sindilimab;Immune-associatedcolitis;Lungcancer;Nurse

免疫检查点抑制剂（ImmuneCheckpointInhibitor,发免疫相关性毒性反应（ImmuneRelatedAdversee