总结1例晚期乳腺癌患者接受帕博丽珠单抗药物治疗后并发免疫相关重症肌无力与心肌炎重叠综合征的护理经验。护理要点如下：需严密观察病情变化，包括肌无力危象监测、肌无力评估与康复以及免疫相关心肌炎的观察，并落实激素冲击治疗的护理；核心症状的精细化护理包括吞咽障碍护理与误吸预防、眼部症状护理；同时提供心理支持与延续性护理。经过21 d的积极治疗与全程护理，患者未出现治疗相关的严重并发症，病情平稳且顺利出院。

To summarize the nursing experience of one patient with advanced breast cancer who developed overlap syndrome of immune-related myasthenia gravis and myocarditis after Pembrolizumab treatment. There were three key nursing points: close monitoring of disease progression, including the monitor of myasthenic crisis, evaluation and rehabilitation of myasthenia gravis, and observation of immune-related myocarditis, together with targeted nursing care during hormone pulse therapy; refined nursing for core symptoms including nursing for dysphagia, aspiration prevention, and ocular symptoms; psychological support and continuous nursing. After 21 days of active treatment and comprehensive nursing, no severe treatment-related complications occurred in the patient,whose condition was stable,and was discharged successfully.

R473.73

上海市护理学会2023年优秀青年人才育苗计划（沪护会〔2022〕20号）