ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (7): 853-855.doi: 10.3761/j.issn.2096-7446.2025.07.015

• 重症护理研究 • 上一篇    下一篇

系统性红斑狼疮患儿行嵌合抗原受体T细胞治疗的护理

费玲(), 陈秀萍, 章毅, 杨挺, 陈芷涵, 诸纪华()   

  1. 310052 杭州市 国家儿童健康与疾病临床医学研究中心/浙江大学医学院附属儿童医院风湿免疫科（费玲，杨挺，陈芷涵），护理部（陈秀萍，诸纪华），神经内科（章毅）
  • 收稿日期:2024-10-15 出版日期:2025-07-10 发布日期:2025-07-04
  • 通讯作者: 诸纪华 E-mail:370810444@qq.com;jihuazhu@zju.edu.cn
  • 作者简介:费玲：女，本科（硕士在读），主管护师，护士长，E-mail：370810444@qq.com

Nursing care of a child with systemic lupus erythematosus treated with chimeric antigen receptor T-cells

FEI Ling(), CHEN Xiuping, ZHANG Yi, YANG Ting, CHEN Zhihan, ZHU Jihua()   

  • Received:2024-10-15 Online:2025-07-10 Published:2025-07-04
  • Contact: ZHU Jihua E-mail:370810444@qq.com;jihuazhu@zju.edu.cn

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摘要：

总结1例系统性红斑狼疮患儿开展嵌合抗原受体T细胞免疫疗法（chimeric antigen receptor T-cells，CAR-T）的护理体会。护理要点：输注前成立多学科团队，制订个性化评估表，落实高风险防范措施；精准回输CAR-T细胞，严密监护；输注后加强对细胞因子释放综合征和免疫效应细胞相关神经毒性综合征等不良反应的管理，使患儿顺利度过危险期；同时，关注患儿心理，做好趣味性叙事护理。通过个体化治疗和护理，患儿病情得到有效控制，顺利出院；回输后3个月，系统性红斑狼疮病情活动指数降至0，24 h尿蛋白降至62.5 mg。

关键词: 嵌合抗原受体T细胞治疗, 儿童系统性红斑狼疮, 细胞因子释放综合征, 免疫效应细胞相关神经毒性综合征, 危重症护理

Abstract:

To summarize the nursing experience of chimeric antigen receptor T-cell（CAR-T） immunotherapy in a child with systemic lupus erythematosus. The key nursing points included：setting up a multidisciplinary team before infusion to develop a personalized assessment scale and implement high risk prevention，precise reinfusion of CAR T-cells and close monitoring，strengthening the management of adverse reactions such as cytokine release syndrome and immune effector cell-related neurotoxic syndrome after infusion. At the same time，the team paied attention to children’s psychology and did fun narrative nursing. Through individualized treatment and nursing，the child’s condition was effectively controlled and discharged smoothly. Three months after transfusion，the disease activity index of systemic lupus erythematosus decreased to 0，and the 24-hour urine protein decreased to 62.5 mg.

Key words: Chimeric Antigen Receptor T-cell Therapy, Systemic Lupus Erythematosus in Children, Cytokine Release Syndrome, Immune Effector Cell-Associated Neurotoxicity Syndrome, Critical Care Nursing