环磷酰胺冲击治疗肾病综合征致不良反应的观察及护理

Observation and nursing of adverse reactions caused by primary nephrotic syndrome treated with cyclophosphamide shock therapy

目的分析环磷酰胺冲击治疗肾病综合征(PNS)致不良反应的发生特点,总结观察与护理经验。方法 2013年2月至2016年2月,选择我院采用环磷酰胺冲击治疗的PNS患者共74例。患者均采用常规治疗,连续2 d给予大剂量静脉滴注,此后连续进行维持治疗,74例患者巩固治疗1.5~2年。给予患者急性期护理、冲击治疗护理。观察患者不良反应发生情况。结果冲击治疗期间,出现1例消化道症状、1例出血性膀胱炎、1例毛发减少,不良反应总发生率为4.05%(3/74)。出院维持用药,患者不良反应总发生率为8.11%(6/74)。在巩固治疗期间,未见明显的不良反应。结论环磷酰胺冲击治疗肾病综合征致不良反应类型较多,需重视急性期的预防护理与后期随访,督促患者做好自我管理。

Objective To analyze the characteristics of adverse reactions caused by primary nephrotic syndrome(PNS)treated with cyclophosphamide shock therapy,summary observation and nursing experience.Methods Seventy-four cases of PNS patients who treated with cyclophosphamide shock therapy in our hospital from February 2013 to February 2016 were selected.Patients were accepted conventional treatment and given continuous large dose drip for 2 days and maintenance treatment thereafter,and seventy-four patients were consolidate treated for 1.5 t o 2 years.Patients were given the nursing of acute stage and the nursing of shock therapy.The adverse reactions of the patients were observed.Results There were 1 case of digestive tract symptoms,1 case of hemorrhagic cystitis,1 case of hair loss in the period of shock therapy,the total incidence rate of adverse reations was 4.05%(3/74).In the period of the discharge and maintain medication,the total incidence rate of adverse reactions was 8.11%(6/74).There was no obvious adverse reactions in the consolidation treatment period.Conclusion Adverse reactions caused by primary nephrotic syndrome treated with cyclophosphamide shock therapy has differtent types and we should pay attention to preventive nursing in acute stage,pay attention to follow-up in late treatment and supervise patients to manage themselves.