摘要
目的总结血浆置换治疗重型病毒性肝炎的常见并发症,探讨其护理方法。方法131例重型肝炎,在内科综合治疗的基础上,采用日本旭医疗公司生产的plasato IQ型人工肝治疗机,中空纤维膜型血浆分离器op-08W型连接pT900管路,进行血浆置换(pE)治疗。每次治疗时间2-3h,血浆置换量为3000mL,间隔3~7d治疗1次,每例酌情治疗1-6次。观察临床疗效,记录并发症的发生情况,并给予相应护理措施。结果131例重型肝炎病人经262次血浆置换治疗,有效110例(83.9%),共发生并发症100例次(38.1%),计有过敏反应82例次(3113%)其中有68例次(25.9%)轻微皮肤瘙痒,12例在治疗中、2例在治疗后出现直径0.5—1.0cm大小的荨麻疹(约2~10个)。18例次(6.8%)发生低血压,均在治疗中出现,血压平均下降(16+6)mmHg左右,28例次(10.6%)出现口唇、下肢麻木及轻度手足抽搐等症状。跨膜压(TMP)增高2例次(0.7%),动脉压(Pa)增高5例次(1.9%),所有并发症经及时对症处理后均消失,无因此加重病情情况发生。结论PE治疗安全有效,但有较高(38.1%)并发症的发生率,如能遵循其发生的内在规律适时恰当处理,不影响病人的PE治疗及预后。
objective To summarize the common complication of serious hepatitis treated by plasmapheresis (PE) and approach the nursing method about that. Methods Using the Artificial liver therapeutic machine, plasato IQ-type, produced by Japanese Asahi Kasei, which was hollow fiber blood plasma separator,op-08W-type,connecting pT 900 channel, to treat 131 patients who was in Serious Hepatitis by plasmapheresis at the foundation of combined therapy, Time of therapy was 2-3h, and once every 3-7d. The volume of plasmapheresis was 3000ml. plasmapheresis was used 1-6 times. Observing the effect and the occurrence of complication, and then giving corresponding nursing. Result In 263 times of plasmapheresis in 131 patients, effective rate was 83.9% (110/131), complication incidence rate was 38,1% (100/263), anaphylactic response rate was 31.3% (82/263). Symptoms of lightly Itch of skin were found in 68 samples (25.9%), urticaria were found in 12 patients during treatment and 2 after treatment And hypopiesia happended in the course of treatment at 18 samples (6.8%), descended (16±6)mmHg average, Symptoms of labia otis, the lower limbs anaesthesia and light limbs hyperspasmia et al, were found in 28 samples(10.6%). Transmembrane pressure (TMP) was increased in 2 samples (0.7%), arterial pressure (Pa) was increased in 5 samples (1.9%). All the complications were disappeared during treatment in time, Conclusions plasmapheresis (PE) is safe and effective, but the complication incidence rate was high (38,1%), given effective management at the proper time, it would not affect plasmapheresis (PE) and prognosis.
出处
《世界感染杂志》
2008年第4期296-298,共3页
World Journal of Infection