高脂血症患者行二重滤过血浆置换治疗的护理

Nursing for Patients with Hyperlipemia Receiving by Double Filtration Plasmapheresis

目的 探讨高脂血症患者行二重滤过血浆置换疗法 (doublefiltrationplasmapheresis,DFPP)的疗效及护理。方法 DFPP前后抽血查全套血脂、分析血脂的变化、DFPP操作及护理措施。结果 5 3例患者 1次DFPP后 ,总胆固醇下降 97.5 % ,甘油三酯下降 91.3%。DFPP过程中 1例一级膜发生凝血 (占 1.89% ) ,2例出现低血压 (占3.77% ) ,3例出现发冷、心慌 (占 5 .6 6 % )。结论 DFPP能显著降低血脂水平 (P <0 .0 1)。护理上注意置换液的平衡 ,血流量和分浆量不宜过快 ,跨膜压 (TMP)、血浆入口压 (Ps)值不能过高 。

Objective To explore the effects and nursing of the double filtration plasmapheresis (DFPP) on patients with hyperlipemia. Methods Blood lipids were measured before and after plasma exchange. The operation and nursing of DFPP were evaluated. Results The levels of total cholesterol and the triglyceride in 53 patients were decreased by 97.5% and 91.3% respectively after the 1st DFPP. During the double filtration plasmapheresis, two patients had blood coagulation and hypotension respectively,and three patients felt cold and palpitations. Conclusion DFPP can decrease the level of blood lipids in patients with hyperlipemia(P<0.01).As for nursing , the fluctuation of blood volume must be avoided, the balance of the liquid quantity out and into the vessels of patients should be observed. The blood flow and the separated plasma flow avoid too fast . The transmembrane pressure (TMP) and the plasma entrance pressure should not be too high. Heparin has to be applied appropriately.