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 ›› 2026, Vol. 7 ›› Issue (7): 841-845.doi: 10.3761/j.issn.2096-7446.2026.07.010

• 急症护理研究 • 上一篇    下一篇

儿童复发难治性急性B淋巴细胞白血病患儿行多部门协作管理的实践

陈凤云1(), 诸纪华2,*(), 朱淑贞1, 王燕青3, 刘艳梅1   

  1. 1 浙江大学医学院附属儿童医院急诊科 杭州市 310000
    2 浙江大学医学院附属儿童医院护理部 杭州市 310000
    3 浙江大学医学院附属儿童医院血液科 杭州市 310000
  • 收稿日期:2025-07-20 出版日期:2026-07-10 发布日期:2026-07-01
  • 通讯作者: *诸纪华，E-mail：Jihuazhu@zju.edu.cn
  • 作者简介:陈凤云：女，本科，护师，E-mail：453180064@qq.com
    作者贡献声明

    陈凤云：研究方案设计及实施、文章撰写；诸纪华：研究指导及支持；朱淑贞、王燕青：研究实施、质量评价；刘艳梅：采集数据与分析

The practice of multi-department collaborative management for children with relapsed and refractory acute B lymphoblastic leukemia

CHEN Fengyun1(), ZHU Jihua2,*(), ZHU Shuzhen1, WANG Yanqing3, LIU Yanmei1   

  1. 1 Emergency Department， the Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310000， China
    2 Nursing Department， the Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310000， China
    3 Hematology Department， the Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310000， China
  • Received:2025-07-20 Online:2026-07-10 Published:2026-07-01
  • Contact: *ZHU Jihua，E-mail：Jihuazhu@zju.edu.cn

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摘要：

回顾分析了6例接受贝林妥欧单抗治疗的急性白血病患儿在多部门协作管理模式下的临床资料，系统探讨该模式对治疗效果和安全性的影响。护理方案整合了病房医护人员对家长培训、急诊科用药流程优化及远程家庭用药支持三大核心模块。结果显示，6例患儿中3例顺利完成治疗；1例出现中心静脉堵管（治疗末期），2例发生过敏反应，经及时溶栓及抗过敏处理后均完成疗程。所有患儿均未出现肿瘤溶解综合征、神经系统症状、严重感染或重要脏器损伤等严重不良反应。多部门协作管理模式在保证达到治疗标准的情况下，显著提升了患儿的治疗依从性及家长的满意度。

关键词: 急性淋巴细胞白血病, 贝林妥欧单抗, 急诊科, 多学科诊疗, 儿童, 护理

Abstract:

This study retrospectively analyzed the clinical data of six pediatric patients with acute lymphoblastic leukemia（ALL） who underwent blinatumomab therapy under the multi-departmental collaborative management model，and systematically evaluated its impact on treatment efficacy and safety. The integrated nursing protocol comprised three core components，including structured training for caregivers，optimized medication administration workflows in the Emergency Department（ED），and remote home-based medication support. Among the six patients，three achieved successfully completed the treatment. Adverse events included one case of central venous catheter occlusion（occurring at the end of treatment） and two allergic reaction；both were successfully managed with timely thrombolysis and anti-allergy therapy，allowing treatment completion. Notably，no severe adverse reactions—such as tumor lysis syndrome，neurological symptoms，severe infections，or critical organ dysfunction—were observed. The findings demonstrated that the multi-departmental collaborative model significantly enhance treatment adherence in pediatric patients and caregiver satisfaction while maintaining standardized therapeutic quality.

Key words: Acute Lymphoblastic Leukemia, Blinatumomab, Emergency Department, Multi-disciplinary Team, Pediatric, Nursing