肾穿刺活检术后体位性低血压的护理策略

目的探讨护理干预对肾穿刺活检术后体位性低血压的影响。方法选取2012年1月至2013年3月在北京大学人民医院肾内科病房行经皮肾穿刺活检术的老年患者60例病人,其中30例采用常规护理,标记为对照组,另外30例采用护理干预,标记为治疗组。结果治疗组在发病原因了解率93.3%高于对照组40%,治疗组在如何预防体位性低血压的了解率90%高于对照组50%,治疗组在如何处理体位性低血压的了解率86.7%高于对照组33.3%,结果具有统计学意义(P【0.05)。对照组满意度55.6%远低于治疗组94.4%,结果具有统计学意义(P【0.05)。对照组满意度66.7%远低于治疗组96.7%,结果具有统计学意义(P【0.05)。结论护理干预可以使肾穿刺活检术后体位性低血压病人获得更多的防治知识,降低肾穿刺活检术后体位性低血压的发生率,使病人能够尽快的康复。

膜性肾病合并系统性淀粉样变性

老年男性患者,临床表现为肾病综合征,肾活检证实为肾小球膜性肾病、肾间质淀粉样变性;皮肤脂肪组织淀粉样变性。最终诊断膜性肾病合并系统性淀粉样变性。

自身免疫性疾病合并系统性轻链淀粉样变性

育龄期女性,临床表现多系统损害、自身抗体阳性、补体下降,同时血免疫固定电泳见游离λ轻链单克隆条带;肾脏损害表现尿检异常伴血清肌酐升高,肾活检证实为肾脏淀粉样变性(AL型);皮肤脂肪组织、骨髓活检均示淀粉样变性。最终诊断自身免疫性疾病合并原发性系统性淀粉样变性(累及肾脏、皮肤、心脏、骨髓)。

Fabry disease combined with acute interstitial nephritis:one case and literature review

Objective:To explore the clinical and pathological features of Fabry disease complication of acute interstitial nephritis.Methods:A retrospective analysis of a patient with Fabry disease and acute interstitial nephritis diagnosed and in the Department of Nephrology,Children’s Hospital Affiliated to Capital Institute of Pediatrics in January 2017 was performed.A literature search was performed with“Fabry disease,acute interstitial nephritis”as the keywords in Wanfang database and PubMeds database.Result:The patient was 10-years-old with acute renal dysfunction.Electron microscopy showed stratified myelin-like bodies,zebra bodies and fused foot segment.The patient was finally diagnosed with the combination of Fabry disease and acute interstitial nephritis.By now,such cases have been reported.Conclusion:Whether Fabry's disease and acute interstitial nephritis shared the common pathogenic mechanism is unclear.Early renal biopsy is important for the diagnosis of this disease.