连续流动离心式血浆置换治疗危重症患者的护理  

Nursing of critical patients receiving plasma exchange with continued flow centrifugal method

作　　者：刘兴玲[1,2] 吴远军[3] 吴勇[3] 李惠森 刘艳[3] 陈宝婵[3] 吴月勤[3] 辛文[3] 杨敏[3] 

机构地区：[1]南方医科大学附属东莞市石龙人民医院 [2]东莞市第三人民医院,广东东莞523326 [3]中山大学附属东华医院,广东东莞523110

出　　处：《现代临床护理》2015年第1期36-40,共5页Modern Clinical Nursing

摘　　要：目的探讨血浆置换治疗(therapeutic plasma exchange,TPE)危重症患者的护理要点。方法对112例具有TPE适应证的危重症患者采用连续流动离心式TPE共251例次,配合做好护理工作。结果 112例患者临床症状及实验检测指标均取得了改善,达到了预期效果;治疗过程中出现低血钙反应63例次(25.10%),过敏反应13例次(5.18%),短暂低血压反应7例次(2.79%),胃肠道反应5例次(1.99%)。结论采用连续流动离心式TPE危重症患者,取得了较好的治疗效果,但治疗过程可出现循环血容量失衡、低血钙、过敏、胃肠道等不良反应,治疗过程应严密观察患者病情的变化,掌握TPE治疗各项指标,重点监测并维持患者循环动力学平衡,及时防治低血钙、过敏等不良反应的发生。Objective To explore the key points of nursing critical patients receiving therapeutic plasma exchange（TPE）with continued flow centrifugal method. Methods Using continued flow centrifugal plasma exchange, 112 patients with indications of plasma exchange received the TPE for 251 times in total. Cooperative nursing was done all through the treatment course.Results The clinical symptoms and the experiment testing indexes of 112 patients were improved to the predictive effect. There were 63（25.10%） cases of low blood calcium, 13（5.18%） cases of allergic reactions, 7（2.79%） cases of low blood pressure response and 5（1.99%） cases of gastrointestinal reaction in the process of treatment. Conclusions Continued flow centrifugal plasma exchange is effective in rescuing critical patients. But it is susceptive to such adverse reactions as unbalance of patient′s circulatory blood volume, low blood calcium, allergic reactions and gastrointestinal reaction. Therefore, the patients′ conditions related to the indexes of TPE should be closely observed during the treatment course, mainly focusing on the maintenance of circulation dynamics balance and prevention of adverse reactions such as low blood calcium, allergic reactions, etc.

关 键 词：血浆置换治疗 危重患者 护理 

分 类 号：R473.5[医药卫生—护理学]