摘要
Abstract
Objective To explore the clinical application and effectiveness of evidence-based predictive nursing on patients with relapsed/refractory B-cell lymphoma undergoing chimeric antigen receptor(CAR)T-cell therapy.Methods Eighty patients with relapsed/refractory B-cell lymphoma who underwent CAR T-cell therapy at Ruijin Hospital between January 2022 and May 2023 were enrolled in the study.Using the envelope method,the patients were randomly assigned to either a control group(n=40),receiving standard nursing care,or an intervention group(n=40),receiving predictive nursing based on evidence-based practice.The intervention included structured problem identification,targeted evidence collection,and implementation of proactive nursing strategies.Clinical outcomes which were compared between the two groups included psychological status,fatigue severity,and treatment-related complications.Results Before nursing intervention,there were no significant differences in anxiety or depression scores between the two groups.After intervention,the intervention group showed significantly lower anxiety and depression scores(P<0.05).Fatigue levels and related dimensions(behavioral,emotional,cognitive,and sensory)also improved significantly in the intervention group compared with the control group(P<0.05).The incidence of cytokine release syndrome(CRS)and immune effector cell-associated neurotoxicity syndrome(ICANS)was lower in the intervention group(65.00%and 15.00%,respectively)than that in the control group(82.50%and 27.50%).There was no significant difference in the overall rate of adverse events between the two groups.There was one case of grade 3-4 CRS and none grade 3-4 ICANS in the intervention group,while there were three cases of grade 3-4 CRS and one case of grade 3-4 ICANS in the control group.Conclusions Evidence-based predictive nursing demonstrates clear clinical value in the management of patients undergoing CAR T-cell therapy with relapsed/refractory B-cell lymphoma.It effectively alleviates psychological distress,reduces fatigue,lowers the risk of severe toxicities,and enhances overall safety and quality of care.These findings support its broader implementation in clinical practice.关键词
循证医学/预见性护理/CAR-T细胞免疫治疗/复发/难治性B细胞淋巴瘤/应用效果Key words
Evidence-based nursing/Predictive nursing/Chimeric antigen receptor T-cell therapy/Relapsed/refractory B-cell lymphoma/Application effect分类
医药卫生
