Intravenous immunoglobulin accompanied with high-dose methylprednisolone therapy for 17 children with anti-N-methyl-D-aspartate receptor encephalitis:Clinic and nursing  

作　　者：Huihan Zhao Yunli Han Yu He Huiqiao Huang Qin Wei Pengpeng Wang Yanping Ying 

机构地区：[1]The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China [2]Department of Pediatrics,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China [3]Department of Clinical Laboratory,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China [4]Department of Nursing,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,China

出　　处：《International Journal of Nursing Sciences》2016年第4期385-389,共5页国际护理科学（英文）

基　　金：We thank the First Affiliated Hospital of the Guangxi Medical University for supplying the case data.We also thank teachers in the pediatric department for their assistance.

摘　　要：Objective:An increasing number of pediatric patients are being diagnosed with anti-N-methyl-Daspartate receptor(NMDAR)encephalitis,whose treatment requires immunotherapy through nursing interventions.This study aimed to analyze the clinical features and long-term prognosis of pediatric anti-NMDAR encephalitis and to gather nursing experiences of immunotherapy.Methods:Seventeen children diagnosed with anti-NMDAR encephalitis were admitted to the pediatric department.They were subjected to a therapy of intravenous immunoglobulin(IVIG)accompanied with high-dose methylprednisolone(HDMP).Multidisciplinary cooperation and intensive care were used to manage them.The effects of nursing intervention and therapy were repeatedly assessed and analyzed throughout the course of treatment and recovery.Results:None of the patients manifested adverse drug reaction(ADR)during IVIG administration.At the first administration of HDMP,ADRs were promptly and efficiently treated in four patients(24%;i.e.,one case each of hyperglycosemia,hypertension,aggravated symptoms,and gastrointestinal bleed).Two patients underwent rehabilitation,and six patients received hyperbaric oxygenation during hospitalization.Nine patients with indwelling gastric tubes experienced four times of unplanned extubation.Hospital stay ranged from 11 days to 59 days,with the mean duration of 26 days.Discharge evaluation revealed that 16 patients who scored 0e2 on the modified Rankin scale presented obvious remission,and one patient who had a mRS score of 4 exhibited less improvement.The mRS scores of hospitalization,discharge,and six-month follow-up displayed statistically significant differences.Conclusions:Nursing interventions of immunotherapy ensures the security of IVIG administration.Multidisciplinary cooperation promotes remission.Our findings can serve as reference for healthcare teams.

关 键 词：Anti-N-methyl-D-aspartate receptor ENCEPHALITIS IMMUNOGLOBULIN METHYLPREDNISOLONE Immunotherapy NURSING Multidisciplinary 

分 类 号：R47[医药卫生—护理学]