重症抗N—甲基—D—天冬氨酸受体脑炎患儿的早期识别及护理

Early identification and nursing care of children with severe anti-N-methyl-D-aspartate receptor encephalitis

总结18例重症抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患儿的早期识别及护理经验。针对该组患儿症状复杂多样、病情进展快、严重神经功能障碍、喂养困难等问题,做好病情评估,协助医生早期确诊;早期识别和处理中枢性通气不足;快速进行癫痫持续状态严重程度评分,多学科协作管理;选择合适的肠内营养途径和方法,做好营养饲管维护;制订分阶段康复方案,做好利妥昔单抗的全程管理。该组病例全部好转出院,门诊随访病情稳定。

To summarize the nursing experience of 18 children with severe anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis.In view of the complex and diverse symptoms of the children in this group,the rapid progress of the disease,severe neurological dysfunction,feeding difficulties and other problems,the following nursing measures were implemented,including the assessment of the condition to help doctors diagnose the disease as soon as possible,early identification and management of central ventilation deficiency,rapid evaluation of the severity of epileptic persistent state and multidisciplinary management,choosing the proper way and method of enteral nutrition and maintenance of the nutrition feeding tube,phased rehabilitation nursing and whole process management of rituximab.All the patients were recovered and discharged,and their condition were stable in outpatient follow-up.