抗结核药物使用引起患者肾损害的分析与护理

Analysis and nursing on impairment of renal function caused by applica- tion of antituberculosis drugs

目的 分析抗结核药物使用引起患者肾损害的护理.方法 选择2010年12月～2012年12月深圳市宝安区慢性病防治院收治的抗结核药物使用引起肾损害患者84例,分析其临床特点、肾损害原因药物以及治疗护理前后的肾功能指标变化情况.结果 肾损害原因药物有利福平41例（48.8％）,对氨水杨酸钠23例（27.4％）,乙胺丁醇20例（23.8％）.结束治疗后患者血肌酐（Cr）、尿素氮（BUN）以及尿酸（UA）指标[（82.9±8.1）μmol/L、（5.1±1.1）mmol/L、（111.8±45.5） μmol/L]均显著优于治疗前[（106.5±13.6）μmol/L、（6.7±1.2） mmol/L、（329.4±88.2） μmol/L],差异均有统计学意义（P＜ 0.05）.结论 抗结核药物可能引起肾损害,在临床用药中应密切监测患者的肾功能指标,并及时予以科学合理的个体化治疗方案和护理方案,减少抗结核药物使用后肾功能损害,改善临床预后.

Objective To analyze the nursing on impairment of renal function caused by application of antituberculosis drugs.Methods 84 cases of renal damaged patients caused by application of antituberculosis drugs from December 2010 to December 2012 in Chronic Diseases Prevent and Cure Hospital of Bao＇an District in Shenzhen City were selected randomly; the clinical characteristics,renal damage inducing drugs and renal function indexes before and after treatment were analyzed.Results 41 cases （48.8%） of renal damage were caused by application of Rifampicin,23 cases （27.4%） were caused by application of sodium Aminosalicylate,20 cases （23.8%） were caused by application of Ethambutol.Cr,BUN,UA after treatment [（82.9±8.1） μmol/L,（5.1±1.1） mmol/L,（111.8±45.5）,μmol/L] were better than those before the treatment [（106.5±13.6） μmol/L,（6.7±1.2） mmol/L,（329.4±88.2） μmol/L],the differences were statistically significant （P 〈 0.05）.Conclusion Antituberculosis drugs may cause renal damage,in clinical medication process,doctors should intimately monitor renal function indexes of patients,and then they should point out reasonable individualized treatment schedules and nursing schedules timely,so as to reduce renal function damage after application of antituberculosis drugs,and these can improve clinical prognosis.