肾移植术后应用抗胸腺细胞球蛋白不良反应的护理

The side effects of using antithymocyte globulin after kidney transplantation

目的观察抗胸腺细胞球蛋白(ATG)在肾移植中诱导治疗和逆转难治性排斥反应的临床效果,总结应用该药物的护理体会。方法回顾性分析1999年2月-2004年2月期间23例应用抗胸腺细胞球蛋白(ATG)诱导治疗或治疗排斥反应的肾移植患者发生不良反应的情况及其护理经验。结果8例应用ATG诱导治疗的患者均未发生急性排斥反应,ATG逆转难治性排斥反应的总有效率为86.7%(13/15)。主要不良反应为消化道出血、发热、寒战和外周血白细胞下降。严格消毒隔离制度,加强呼吸道、泌尿道护理,用药期间加强护理观察,及时调整护理措施有助于减少药物不良反应的发生。结论在肾移植患者中使用ATG进行诱导治疗和逆转难治性排斥反应是有效的。合理的护理措施是保证药物治疗效果、减少不良反应的关键。

Objective To evaluate the side effects of antithymocyte globulin （ATG） in induction and anti-rejection therapies and summarie the nursing management of using the drug. Methods Retrospective analysis was conducted concerning 23 kidney recipients who received ATG from February 1999 to February 2004. Results No acute rejection was found in 8 recipients who received ATG for induction therapy. 86.7% （13/15） anti-steroid rejections were reversed. The major side effects of ATG were hemorrhage of digestive tract, fever, chills and decrease of blood white cell counts. The nursing measures like enforcement of sterilization and isolation system, enhanced nursing of respiratory and urinary tracts, intense observation of nursing care at the use of ATG, timely adjustment of nursing measures, which altogether function to reduce the side effect. Conclusion For kidney recipients, it is effective in the induction and anti-rejection therapies. An appropriate nursing management may contribute the effect of therapy and reduce the side effects.