视神经脊髓炎谱系疾病患者免疫吸附治疗的护理  

Nursing care of patients with neuromyelitis optica spectrum diseases treated with immunoadsorption therapy

作　　者：李莉莉[1] 阮恒芳[2] 沈利平[2] 左珺 邱伟[2] Li Lili;Ruan Hengfang;Shen Liping;Zuo Jun;Qiu Wei(Department of Infectious Disease,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Internal Medicine-Neurology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院感染科,广州510530 [2]中山大学附属第三医院神经内科,广州510530

出　　处：《中国实用护理杂志》2021年第4期286-290,共5页Chinese Journal of Practical Nursing

基　　金：中山大学附属第三医院护理科研基金(2019HL03)。

摘　　要：目的总结蛋白A免疫吸附在视神经脊髓炎谱系疾病患者中的应用效果,探讨护理要点。方法对10例视神经脊髓炎谱系疾病患者行蛋白A免疫吸附治疗,重点做好心理护理,吸附前进行全面评估,确定吸附治疗的处方;吸附治疗时准确预防及处理低血压、血浆分离器的破膜溶血、寒战等各种不良反应;治疗结束后注意预防院内感染、吸附柱再生与保存等。结果免疫吸附治疗后,10例患者血清中IgG水平、抗体、平均扩展残疾状态量表(EDSS)评分有不同程度下降,血清IgG浓度由治疗前的(6.04±2.77)g/L下降至治疗后的(2.23±1.74)g/L,无严重并发症发生,无一例次免疫吸附操作失败,病情均较前好转。结论蛋白A免疫吸附治疗视神经脊髓炎谱系疾病安全、有效,规范的评估、操作和护理是达到良好效果的关键。Objective To explore the application and nursing of protein A immunosorbent in patients with neuromyelitis optica spectrum diseases.Methods Ten patients with neuromyelitis optica spectrum diseases were treated with protein A immunoadsorption therapy.Psychological nursing was emphasized.Comprehensive evaluation was conducted before adsorption to determine the prescription of adsorption therapy.During adsorption therapy,hypotension,membrane rupture and hemolysis of plasma separator,shivering and other adverse reactions were accurately prevented and treated.After treatment,attention should be paid to the prevention of nosocomial infection,regeneration and preservation of adsorption column.Results After immunoadsorption therapy,the serum IgG level,antibody and EDSS score of 10 patients decreased to varying degrees.The serum IgG decreased from(6.04±2.77)g/L to(2.23±1.74)g/L.No serious complications occurred,no failure of immunosorbent operation,and the patients′condition was better than before.Conclusions Protein A immunosorbent therapy for neuromyelitis optica spectrum diseases is safe and effective.Standardized evaluation,operation and nursing are the key to achieve good results.

关 键 词：蛋白A免疫吸附 视神经脊髓炎谱系疾病 护理 

分 类 号：R473.74[医药卫生—护理学]