益赛普治疗强直性脊柱炎的观察和护理

Clinical observation and nursing on Etanercept in the treatment of ankylosing spondylitis

目的:观察益赛普治疗强直性脊柱炎的疗效及不良反应,并探讨护理策略。方法:对22例强直性脊柱炎应用益赛普治疗,分别在0、6、12周评价临床疗效及不良反应,并探讨早期护理干预措施。结果:患者治疗后BAS-DAI、脊柱痛、胸廓扩张度、Schober、脊柱侧弯、踝间距及CRP、ESR等指标在第6、12周时较治疗前均明显改善,差异均有统计学意义(均P<0.05)。22例患者12周内共注射益赛普针396次,6例发生不良反应,其中,5例注射部位局部皮肤出现红肿和硬结伴发痒,1例发热。经早期护理措施干预后无一例因不良反应而终止治疗。结论:益赛普治疗活动性强直性脊柱炎疗效显著,能改善强直性脊柱炎患者的症状、体征、关节功能和生活质量。应用益赛普治疗强直性脊柱炎后注射部位皮肤反应较常见,在适当的护理干预下可减少不良反应的发生和不良反应带来的不适。

Objective： To observe the efficacy, adverse reaction and nursing intervention of Etanercept in patients with ankylosing spondylitis. Methods： 22 patients with active ankylosing spondylitis were treated with Etanercept. During the course of treatment, all subjects were assessed at week 0, 6, 12 respectively. Results： The BASDAI, rachialgia, thoracic expansion, Schober, scoliolosis, intermalleolar distance, CRP, ESR and other indexes at 6 and 12 weeks after treatment were significantly improved compared with those before treatment （all P〈0.05）, and less occurrence of adverse reaction was observed in the nursing interventions. 22 patients were injected Etanercept for 396 times with 12 weeks, 6 cases happened adverse reaction, including 5 cases of local redness and swelling, rashing, 1 case of fever. No case was stopped injection because of reaction. Conclusion： Etanercept can provide substantial benefits to patients with active ankylosing spondylitis by reducing clinical signs and improving range of motion as well as quality of life. Etanercept induced ad- verse reactions of injection site is relatively common, but the nursing interventions can reduce the incidence and severity degree of reaction, and improve the patients compliance, benefits the patients.