神经免疫性疾病患者血浆置换中低血压发生现状及影响因素分析  

The current status and influencing factors of hypotension in Plasma Exchange for patients with neuroimmune diseases

作　　者：龚立超 常红[1,2] 赵洁[2] 王召锋 李含笑 GONG Lichao;CHANG Hong;ZHAO Jie;WANG Zhaofeng;LI Hanxiao(School of Nursing,Capital Medical University,Beijing,100069,China)

机构地区：[1]首都医科大学护理学院,北京市100069 [2]首都医科大学宣武医院神经内科

出　　处：《中国护理管理》2021年第12期1800-1804,共5页Chinese Nursing Management

基　　金：2019年宣武医院院级护理课题资助项目(XWHL-2019021);2017年度北京市医院管理局“职工科技创新工场培育团队”。

摘　　要：目的:调查神经免疫性疾病患者血浆置换中低血压发生现状及影响因素,为临床干预提供依据。方法:采用便利抽样法选取北京市某三级甲等医院神经内科监护室69例行血浆置换的神经免疫性疾病患者为研究对象,采用自制血浆置换资料收集表对血浆置换中低血压发生情况进行调查。结果:69例患者中无低血压发生36例(52.17%),发生轻度低血压9例(13.04%),发生中度低血压24例(34.78%),无重度和极重度低血压发生;多分类有序Logistic回归分析显示置换中使用镇静药物、置换前收缩压是神经免疫性疾病患者血浆置换中低血压严重程度的影响因素(P<0.05)。结论:神经免疫性疾病患者血浆置换中低血压发生率较高,与置换中使用镇静药物、置换前收缩压低相关;应针对低血压危险因素积极采取干预措施,降低血浆置换中低血压的发生率,保证血浆置换治疗安全。Objective:To investigate the current status and influencing factors of hypotension in Plasma Exchange for patients with neuroimmune diseases,so as to provide evidence for clinical interventions.Methods:A total of 69 patients with neuroimmune diseases who underwent Plasma Exchange in the intensive care unit of neurology from a tertiary grade A hospital in Beijing were selected by convenience sampling.The incidence of hypotension during Plasma Exchange was investigated by using a self-designed Plasma Exchange data scale.Results:Among 69 patients,36 cases(52.17%)had no hypotension,9 cases(13.04%)had mild hypotension,and 24 cases(34.78%)had moderate hypotension.No severe hypotension or death occurred.Multivariate ordered logistic regression analysis showed that the use of sedative drugs and systolic blood pressure before Plasma Exchange were the influencing factors of hypotension in Plasma Exchange for patients with neuroimmune diseases(P<0.05).Conclusion:The incidence of hypotension in Plasma Exchange for patients with neuroimmune diseases is relatively high,which is related to the use of sedative drugs and the systolic blood pressure before Plasma Exchange.Interventions should be taken for the influencing factors of hypotension to reduce the incidence of hypotension in Plasma Exchange and ensure the safety of Plasma Exchange.

关 键 词：神经免疫性疾病 血浆置换 低血压 影响因素 护理 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]