系统性红斑狼疮合并肠系膜血管炎患者的护理

Nursing of systematic lupus erythematosus patients with mesenteric vasculitis

目的探讨系统性红斑狼疮合并肠系膜血管炎的护理。方法对32例系统性红斑狼疮合并肠系膜血管炎患者的不同症状进行针对性治疗和护理,观察症状并总结护理经验。结果 32例患者中胃肠道症状包括腹痛31例(96.9%)、恶心和(或)呕吐29例(90.6%)、腹泻13例(40.6%)、腹胀11例(34.4%)、肛门停止排气6例(18.8%)、黑便和(或)血便2例(6.3%),胃肠道外症状包括肾脏受损22例(68.8%)、腹盆腔积液21例(65.6%)、血液系统受损17例(53.1%)、皮疹15例(46.9%)、发热(大于37.5℃)11例(34.4%)、雷诺现象8例(25%)、关节痛6例(18.8%)、口腔溃疡5例(15.6%)、狼疮脑病1例(3.1%),经对症治疗与护理均治愈出院。结论系统性红斑狼疮合并肠系膜血管炎的护理要点是密切监测患者生命体征变化,及早发现和处理胃肠道症状,并予以禁食、胃肠减压、营养支持等治疗,避免进展恶化成肠穿孔或肠坏死,此外还应密切观察和处理胃肠道外症状,并做好饮食、用药及心理的护理。

Objective To discuss nursing of systematic lupus erythematosus（ SLE） patients with mesenteric vasculitis. Methods Corresponding therapy and nursing were given to 32 SLE patients with mesenteric vasculitis according to the different symptoms and the nursing experiences were summarized. Results The gastrointestinal symptoms of 32 patients contained stomachache in 31 cases（ 96. 9%）,nausea and（ or） vomiting in 29 cases（ 90. 6%）,diarrhea in 13 cases（ 40. 6%）,abdominal distension in 11 cases（ 34. 4%）,exhaust stopping of anus in 6 cases（ 18. 8%）,black stool and（ or） blood stool in 2 cases（ 6. 3%）. And parenteral symptoms contained kidney damage in 22cases（ 68. 8%）,abdominal and pelvic effusion in 21 cases（ 65. 5%）,blood system damage in 17 cases（ 53. 1%）,skin rash in 15 cases（ 46. 9%）,fever（ over 37. 5℃） in 11 cases（ 34. 4%）,Reynolds phenomenon in 8 cases（ 25%）,arthralgia in 6 cases（ 18. 8%）,oral ulcer in 5 cases（ 15. 6%）,and lupus encephalopathy in 1 case（ 3. 1%）. All the patients were successfully discharged after corresponding therapy and nursing. Conclusion The nursing points of SLE and mesenteric vasculitis are close monitoring of vital signs changes,early detection and treatment of gastrointestinal and parenteral symptoms,and treatment of fasting,gastrointestinal decompression and nutritional support to avoid enterobrosis and intestinal necrosis. Besides,close observation and treatment of gastrointestinal symptoms and nursing in diet,medication and psychology should be given to these patients.