单纯血浆置换治疗肝衰竭不良反应的预防及护理

Prevention and nursing care of adverse reactions in the single plasma exchange treatment of liver failure

目的观察单纯血浆置换治疗肝衰竭患者常见的不良反应和意外情况,分析其相关原因和处理对策。方法回顾性总结肝衰竭536例共1352人次在治疗过程中发生的不良反应及其原因。结果治疗中共发生不良反应82人次,其中过敏反应31人次,血压下降24人次,昏迷、躁动12人次,出血6人次,置管脱出3人次,管路堵塞3人次。结论单纯血浆置换治疗过程中积极去除诱因,实施科学的治疗与护理是减少不良反应的发生,保证治疗顺利完成的重要因素。

Objective To investigate the adverse reactions and accidents in the single plasma exchange （SPE） treatment in patients with liver failure, analyze relevant causes and explore the strategies to prevent those events. Methods Adverse reactions occurring in the SPE treatment of 536 patients with liver failure （1 352 person-times） were summarized retrospectively, and the relevant causes were analyzed meanwhile. Results Adverse reactions occurred in 82 person-times： allergic response in 31 person-times, blood pressure decrease in 24 person-times, coma or restlessness in 12 person-times, bleeding in 6 person-times, venous catheter falling off in 3 person-times and catheter obstruction in 3 person-times. Conclusion It is very important to avoid the possible causative factors and to enforce scientific treatment and nursing care in the SPE treatment so as to reduce adverse reactions and ensure that the SPE treatment goes smoothly.