MOG抗体相关性脑脊髓炎的临床特征及护理措施研究

Clinical characteristics of patients with MOG antibody associated encephalomyelitis and nursing measures

目的:分析MOG抗体相关性脑脊髓炎(MOG-EM)患者的临床病例特征并制定相应的针对性护理策略,期望为疾病的治疗和康复提供帮助。方法:选取三九脑科医院神经内科住院的88例MOG-EM患者,分析其临床特征和发病特点制定针对性的护理方法,按照主要临床特点将患者平均分为常规护理组(n=44)和循证护理组(n=44例),探讨不同护理策略对疾病的护理效果。结果:纳入患者临床首发症状主要表现为癫痫发作、视力下降为主,单纯MOG抗体阳性有69例。研究结果显示,循证护理组患者的平均住院时间显著少于常规护理组;常规护理组患者中有5例未出现任何并发症,循证护理组患者中有21例未出现任何并发症,常规护理组患者泌尿系统感染、压疮、应激性溃疡和焦虑症等主要并发症发生率显著高于循证护理组;循证护理组治愈及好转率为86.42%,而常规护理组为79.54%;平均随访患者13.2个月,常规护理组疾病复发15例,循证护理组复发9例,复发者均接受激素联合免疫治疗,治疗后常规护理组8例完全缓解,5例遗留轻微的症状,2例患者因病情持续性加重而死亡,循证护理组患者在治疗后6例完全缓解,2例遗留轻微症状;循证护理组患者及家属对护理人员的满意度显著高于常规护理组,以上差异均有统计学意义。结论:MOG-EM目前发生发展的病因不清楚,其治疗方式及预后具有不确定性和难度,采取针对性护理策略的循证护理手段可以在一定程度上提高患者临床治疗效果和改善预后。

Objective To analyze the clinical characteristics of patients with MOG antibody associated encephalomyelitis and nursing strategies for treatments.Method Eighty-eight adult patients with MOG-ME who were Sanjiu Brainhospitalized in the Department of Neurology were selected to analyze their clinical characteristics and targeted nursing methods.Patients were divided into routine nursing group(n=44 cases)and the evidence-based nursing group(n=44 cases).To explore the nursing effect of different nursing strategies on diseases.Results The initial clinical symptoms of the patients were mainly seizures and vision loss,69 patients with simple MOG antibody.It showed that the length of hospital stay in evidence-based nursinggroup was significantly less than that inroutine nursing group.There were 5 cases inroutine nursing group without any complications,and 21 cases inevidence-based nursing group.The incidence of urinary tract infection,pressure ulcers,stress ulcers and anxiety disorders inroutine nursing group was significantly higher than that in evidence-based nursinggroup.The patients in evidence-based nursinggroup were basically cured after treatment 26,12 cases were improved,the rate of cure and recovery was 86.42%,while inroutine nursing group cured 20,15 cases were improved,and the rate was 79.54%Following up 13.2 months,the results showed 15 cases of disease recurrence in routine nursing group,9 cases of evidence-based nursinggroup.Treated with hormone combined immune,8 cases complete remission after treatment,5 cases of legacy mild symptoms,2 patients died of illness continuous increase inroutine nursing group,6 cases of patients with complete response,2 cases of minor residual symptoms inevidence-based nursing group.The satisfaction with nursing staff inevidence-based nursing group was significantly higher than that in routine nursing group.Conclusion At present,the etiology of MOG antibody associated encephalomyelitis is not clear,and its treatment and prognosis are uncertain and difficult.Evidence-based nursing using targeted nursing strategies can improve the clinical treatment and prognosis of patients.