ABSTRACT
Objective To observe the effects of continuous care on acute leukemia (AL) children with PICC in remission induction stage after discharge from hospital. Methods 102 AL children with PICC during July 2014 and December 2016 were enrolled and then were randomly divided into study group (n=52) and control group (n=50): the control group was given routine discharge guidance, and the study group received continuous care, which contained synchronous health education to children and parents before discharge, home visits, patient management through WeChat platform and lectures and psychological support. The parental care ability and quality of life of children after 3 months were evaluated, and PICC complications were recorded during intubation. Result The self-care ability,negative emotions like anxiety and depression and quality of life in the study group were all significantly improved as compared with the control group and the time for intubation was shorter and the total rate of complications lower as well(P<0.05). Conclusion Continuous nursing can significantly improve the parental self-care ability of the AL children with PICC after discharge,reduce complications from intubation and improve their quality of life and help to improve parent's the negative emotions.
ABSTRACT
Objective To compare the effectiveness and safety of glucocorticoid versus intravenous injection of human immunoglobulin (IVIG) in treatment of with acute primary immune thrombocytopenia (ITP) in children. Methods PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Chinese biomedical literature database (CBM), Chinese Journal Full Text Database (CNKI) and Wanfang database were searched. The bibliography was screened according to the inclusion and exclusion criteria,and the target literatures were selected. The data were extracted and the quality of included literatures was evaluated. Revman 5 . 3 software was used to make meta-analysis. Results In 1500 papers searched, 8 papers met the inclusion criteria. Meta-analysis showed that there was a statistical signiifcance in platelet count (PLT,>20 × 109/L) after being treated for 48 h between glucocorticoid group and IVIG group (RR=0 . 77 , 95%CI:0 . 67~0 . 89 ). In subgroup analysis, there were statistical signiifcance in methylprednisolone (MP) 30 mg/kg versus IVIG 1 g/(kg·d)× 2 d, and metacortandratin (PDN) 4 mg/kg versus IVIG 1 g/(kg·d)× 2 d (RR=0 . 66 , 95%CI:0 . 47-0 . 91;RR=0 . 79 , 95%CI:0 . 66-0 . 95 ). After treatment for 24 h and 72 h, the platelet count>20 × 109/L were signiifcantly different in glucocorticoid group and in IVIG group (RR=0 . 69 , 95%CI:0 . 53-0 . 91;RR=0 . 82 , 95%CI:0 . 74-0 . 90 ). Moreover, after treatment for 24 h, 48 h and 72 h, the platelet count>50 × 109/L were signiifcantly different between glucocorticoid group and IVIG group (RR=0 . 38 ,95%CI:0 . 21-0 . 69;RR=0 . 53 , 95%CI:0 . 41-0 . 69;RR=0 . 80 , 95%CI:0 . 70-0 . 93 ). There was no difference in the incidence of splenic resection between two groups (RR=5 . 41 , 95%CI:0 . 95-30 . 74 , P=0 . 06 ). Conclusion The probability of platelet count to reach>20 × 109/L in the initial treatment with glucocorticoid of acute ITP patients were 32%lower than that with IVIG. With the initial therapeutic target being platelet count>50 × 109/L in 3 days, the effect of IVIG was better.