联合护理对大剂量糖皮质激素冲击治疗重症药疹副作用及并发症的影响分析

Effect of combined nursing on side effects and complications of high dose glucocorticoid pulse therapy for severe drug eruption

目的分析联合护理对大剂量糖皮质激素冲击治疗重症药疹副作用及并发症的影响。方法对我院收治的42例重症药疹患者采用整群随机抽样法分成对照组和观察组各21例,两组患者均应用大剂量糖皮质激素治疗,同时接受健康宣教、皮肤护理等常规护理,观察组在上述基础上联合采用护理干预。观察两组患者血压升高、消化道出血、水电解质紊乱、肝肾功能衰竭及严重感染等并发症情况,检测两组干预前后肿瘤坏死因子-α(TNF-α)水平并进行组间比较,并对两组患者的退热时间及皮疹消退时间进行比较。结果观察组患者的血压升高、消化道出血等副作用及并发症发生率均低于对照组,差异具有统计学意义(均P<0.05)。两组干预后的TNF-α水平均低于干预前(均P<0.05),而且观察组干预后的TNF-α水平低于对照组(P<0.05)。两组患者的退热时间及皮疹消退时间比较,观察组均短于对照组,差异具有统计学意义(均P<0.05)。结论联合护理干预可减少大剂量糖皮质激素冲击治疗重症药疹患者相关并发症,降低炎性因子水平,加快临床症状缓解。

Objective To analyze the influence of combined nursing on the side effects and complications of high-dose glucocorticoid pulse therapy for severe drug eruption.Methods 42 cases of severe drug eruption in our hospital were divided into the control group and the observation group,21 cases in each group.All patients were treated with high-dose glucocorticoid,and received routine nursing such as health education and skin care,while the observation group was treated with combined nursing intervention.The blood pressure,gastrointestinal bleeding,water electrolyte disorder,liver and kidney failure,severe infection and other complications of the two groups were statistically analyzed;the content of tumor necrosis factor-α(TNF-α)before and after the intervention of the two groups was detected and compared between the two groups;the antipyretic time and rash regression time of the two groups were recorded and compared.Results The incidence of side effects and complications in the observation group were lower than those in the control group(P<0.05).After the intervention,the TNF-αlevel of the two groups was lower than that before the intervention,the difference was statistically significant(P<0.05).After the intervention,the TNF-αlevel of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).The antipyretic time and rash regression time of the observation group were shorter than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Combined nursing intervention can reduce the related complications,reduce the level of inflammatory factors,and accelerate the remission of clinical symptoms.