Application effect of modified subcutaneous injection technique in bortezomib therapy for patients with multiple myeloma
改良皮下注射技术在多发性骨髓瘤患者硼替佐米治疗中的应用研究

摘要

目的 探讨改良皮下注射技术在多发性骨髓瘤患者硼替佐米治疗中的应用效果，评估其对注射部位不良反应、疼痛程度及治疗安全性的影响，为临床护理操作优化提供循证依据。方法 选取某三甲医院血液内科2024年11月收治的90例接受硼替佐米皮下注射治疗的多发性骨髓瘤患者，采用随机数字表法分为观察组与对照组，各45例。对照组采用常规皮下注射方法，观察组采用“留置气泡+精准腹部定位”改良注射技术。比较两组注射后12 h皮下出血发生率及严重程度、疼痛视觉模拟评分、注射后72 h硬结与血肿等并发症发生率，并计算药液残留率。结果 观察组重度皮下出血发生率为0，显著低于对照组11.1%（P<0.05）；观察组VAS疼痛评分（2.1±0.8）分，显著低于对照组（4.3±1.2）分（P<0.001）；观察组并发症总发生率6.7%，显著低于对照组24.4%（P<0.05）；观察组药液残留率显著低于对照组（P<0.001）。结论 改良皮下注射技术可显著降低硼替佐米注射相关局部不良反应，减轻疼痛，减少药液残留，提高患者治疗耐受性与舒适度，操作简便、安全可行，符合临床指南与循证护理要求，具有良好推广价值。

Abstract

Objective To investigate the application effect of modified subcutaneous injection technique in bortezomib therapy for patients with multiple myeloma, and to evaluate its influence on local adverse reactions, pain intensity and treatment safety, so as to provide evidence for optimizing clinical nursing practice.
Methods A total of 90 multiple myeloma patients treated with subcutaneous bortezomib in the hematology department of a tertiary hospital in November 2024 were enrolled and randomly divided into observation group and control group, with 45 cases in each group. The control group received routine subcutaneous injection, while the observation group was given modified injection technique with air-lock and precise abdominal site selection. Subcutaneous hemorrhage, pain score, complications (induration, hematoma) and drug residual rate were compared between the two groups.
Results The incidence of severe subcutaneous hemorrhage in the observation group was 0, significantly lower than 11.1% in the control group (P<0.05). The VAS score in the observation group was (2.1±0.8), significantly lower than (4.3±1.2) in the control group (P<0.001). The total complication rate was 6.7% in the observation group and 24.4% in the control group (P<0.05). The drug residual rate was also significantly lower in the observation group (P<0.001).
Conclusion   The modified subcutaneous injection technique can significantly reduce local adverse reactions and pain caused by bortezomib, decrease drug residue, and improve patient tolerance and comfort. It is simple, safe and consistent with clinical guidelines and evidence-based nursing, which is worthy of clinical promotion.