系统性红斑狼疮合并肺动脉高压重度右心衰竭患者的护理

Nursing for severe right heart failure patients with systemic lupus erythematosus complicated with pulmonary hypertension

目的探讨系统性红斑狼疮合并肺动脉高压右心衰竭患者的护理经验。方法对36例系统性红斑狼疮合并肺动脉高压右心衰竭患者,予大剂量注射用环磷酰胺冲击疗法和降肺动脉压靶向治疗,落实专科护理。结果34例患者的临床症状基本缓解,其中8例口腔溃疡经对症护理后3~5 d逐渐愈合,11例合并多浆膜腔积液经对症治疗10~14 d后,水肿逐渐消退,4例入院时收缩压72~84 mmHg、舒张压42~50 mmHg,经强心、扩张肺血管等治疗4~10 d后收缩压92~118mmHg、舒张压55~70 mmHg。本组34例住院14~22 d,均好转出院,2例死亡。结论系统性红斑狼疮合并肺动脉高压重度右心衰竭患者给予全面的治疗与护理,可减少并发症,降低死亡率,改善患者的生活质量。

Objective To explore the nursing experience of severe right heart failure patients with systemic lupus erythematosus complicated with pulmonary arterial hypertension.Methods Thirty-six patients with systemic lupus erythematosus complicated with pulmonary arterial hypertension were given intravenous infusion of injectable cyclophosphamide,anti-pulmonary artery pressure targeted treatment and special nursing care.Results The clinical symptoms of 34 patients were significantly improved.Eight cases had oral ulcers,and were healed in 5 days after special care.Eleven cases had multiple serous cavity effusion,but disappeared gradually in 10 to 14 days after targeted care.The systolic pressure and diastolic pressure in 4 patients was 72~84 mmHg and 42~50 mmHg respectively at admission,and were increased to 92~118 mmHg and 5~70 mmHg respectively after 4 to 10 days of treatment with heart strengthening and pulmonary vasodilator therapy.34 patients were all discharged after 14 to 22 days of hospitalization,and 2 patients died.Conclusion Comprehensive treatment and nursing can reduce complications and mortality rate,and improve quality of life in severe right heart failure patients with systemic lupus erythematosus complicated with pulmonary hypertension.