灾难性抗磷脂综合征患者的护理

Nursing of patients with catastrophic antiphospholipid syndrome

目的 总结13例灾难性抗磷脂综合征患者的护理经验,为临床护理提供参考。方法 对北京协和医院风湿免疫科自2016年1月至2021年9月收治的13例灾难性抗磷脂综合征患者的病历资料及护理措施进行回顾,总结归纳护理要点。结果 对13例患者给予出凝血观察与护理、血浆置换护理、感染控制、用药护理、支持性护理,最终13例患者中8例病情好转出院,5例治疗无效死亡。结论 早期识别患者诱发因素,及时发现患者病情变化,应用三联疗法规范治疗,密切关注出凝血情况,专业的血浆置换护理,积极进行感染控制,有针对性的用药护理,全面的支持护理,是灾难性抗磷脂综合征患者护理的关键。

Objective To summarize the nursing experience of 13 patients with catastrophic antiphospholipid syndrome and provide reference for clinical nursing.Methods The medical and nursing records of 13 patients with catastrophic antiphospholipid syndrome admitted to the Department of Rheumatology and Clinical Immunology of Peking Union Medical College Hospital from January 2016 to September 2021 were reviewed,the disease characteristics and nursing measures were sorted out,and the nursing experience was summarized.Results 13 patients were given coagulation observation and nursing,plasmapheresis nursing,infection control,medication nursing,supportive nursing.Finally,all of the 13 patients,8 patients’conditions improved and they were discharged,5 patients died of ineffective treatment.Conclusions The key factors to nursing patients with catastrophic antiphospholipid syndrome are early identification of the precursors,timely detection of the disease changes,standardized treatment with triple therapy,close attention to the condition of coagulation,professional plasmapheresis nursing,active infection control,targeted medication nursing and comprehensive support nursing.