变应性鼻炎冲击免疫治疗全身不良反应的临床观察与护理  

Clinical observation on the systemic side-effects of patients with allergic rhinitis receiving rush immunotherapy and their nursing strategies

作　　者：李芳丽[1] 华清泉[1] 许昱[1] 雷薇薇[1] 章薇[1] 杨蕊[1] 陈瑾[1] LI Fangli;HUA Qingquan;XU Yu;LEI Weiwei;ZHANG Wei;YANG Rui;CHEN Jin(Dept.of Otorhinolaryngology-Head&Neck Surgery,People’s Hospital of Wuhan University,Hubei,430060,China)

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,武汉430060

出　　处：《中国中西医结合耳鼻咽喉科杂志》2023年第6期451-456,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的总结变应性鼻炎患者实施冲击免疫治疗过程中的全身不良反应及护理经验。方法回顾性分析我科31例变应性鼻炎患者在冲击免疫治疗过程中发生的全身不良反应,总结护理策略。结果31例接受冲击免疫治疗患者共注射442针次,其中6例患者7针次出现全身不良反应(年龄均<18周岁,2例合并哮喘);按人次计全身不良反应发生率为19.35%,按注射次数计全身不良反应发生率为1.58%;发生时间均为治疗开始后的第3d和第4d;其中4例出现以局部或全身荨麻疹、风团、潮红等为主要症状,2例以哮喘发作、干咳、咽喉痒、呼吸困难等为主要症状。结论冲击免疫治疗剂量累加阶段存在全身不良反应风险,护理人员应在治疗前全面评估患者相关潜在危险因素,加强治疗中的护理观察,更好地保障医疗安全。Objective To observe the systemic side-effects occurred at the stage of dose accumulation during the period of rush immunotherapy and to explore their nursing strategies for patients with allergic rhinitis(AR).Methods Included in this trial were 31 AR cases,with their systemic side-effects occurred at the stage of dose accumulation during rush immunotherapy analyzed and their nursing strategies summarized retrospectively to sum up the clinical characteristics and occurring law of this kind of systemic side-effects for developing better nursing procedures.Results In this group of AR patients receiving rush immunotherapy,442 doses in total were given to them.Among them,systemic side-effects were appeared in 6 cases,with a rate of 19.35%out of the all patients,and a total of 7 times of systemic side-effects occurred with a rate of 1.58%out of the total doses injected.All these 6 cases were at the age younger than 6 years old,with 2 of them accompanied with asthma.Systemic side-effects were all developed at the 3rd or 4th day in the period of rush immunotherapy,with local and/or systemic urticaria,wind mass and flushing as the main symptoms in 4 patients and with asthma attacking,dry cough,throat itching,dyspnea and so on in another 2 cases.Conclusion There is a risk of systemic side-effects developing at the stage of dose accumulation during rush immunotherapy.Before the rush immunotherapy started,a comprehensively evaluation on the potential risk factors associated with development of systemic side-effects should be carried out among patients to receive such an immunotherapy for avoiding these events from occurring to ensure medical safety.

关 键 词：变应性鼻炎 冲击免疫治疗 全身不良反应 护理 

分 类 号：R473.76[医药卫生—护理学]