血浆置换在小儿肾脏风湿疾病治疗的应用及护理
Application and nursing of therapeutic plasma exchange on pediatric renal rheumatic diseases
周佳 1张慧 1周清 1赵蕊 1沈霞 1刘帆 1徐虹 1沈茜 1方晓燕1
作者信息
- 1. 201102 上海,复旦大学附属儿科医院肾脏科;201102 上海,复旦大学附属儿科医院国家儿童医学中心;201102 上海,复旦大学附属儿科医院上海市肾脏发育和儿童肾脏病研究中心
- 折叠
摘要
目的 分析治疗性血浆置换术(therapeutic plasma exchange,TPE)在小儿肾脏风湿疾病中的应用及并发症的观察,探讨相关护理对策.方法 回顾2021年1月-2022年12月复旦大学附属儿科医院肾脏和风湿科收治并接受血浆置换治疗的患儿,家属签署知情同意书.经颈内静脉建立血管通路,对9例患儿进行28例次血浆置换治疗.并对患儿的原发病、治疗前后指标、并发症进行分析.结果 9例患儿28例次TPE治疗期间患儿出现过敏反应9例次(32.1％)、低钙血症9例次(32.1％)、低血压4例次(14.2％)、体外循环凝血1例次(3.6％)、导管功能不良1例次(3.6％),28例次通过相应的护理干预后,均顺利完成血浆置换治疗.无其他危及生命的并发症出现.结论 在血浆置换过程中,应对不同疾病儿童临床疗效进行观察,并对出现的常见并发症进行分析,采取相应的护理干预,最大限度的降低并发症带来的副作用,提高临床疗效,确保血浆置换临床运用的安全性.
Abstract
Objective To analyze the application of therapeutic plasma exchange(TPE)and its compli-cations in pediatric renal rheumatic diseases,and to explore the relevant nursing strategies.Methods The chil-dren undergoing TPE at the Department of Nephrology and Rheumatology,Fudan University Children's Hos-pital from January 2021 to December 2022 were retrospectively studied.Informed consent was obtained from the family of the patient.Vascular access was established through an internal jugular vein.The Prismaflex blood purification machine was used to perform TPE in a total of 28 times for 9 patients.The primary diseases of the patients,pre-and post-TPE indicators,and the presence of complications were analyzed.Results Com-plications occurred in the 28 times of TPE for the 9 patients,including allergic reactions 9 times(32.1％),hy-pocalcemia 9 times(32.1％),hypotension 4 times(14.2％),coagulation in extracorporeal circulation once(3.6％),and catheter malfunction once(3.6％).After appropriate nursing interventions,the complications were resolved,and TPE treatments completed successfully without any other life-threatening events.Conclusion In the processes of TPE,clinical efficacy on children with different diseases should be observed,and TPE complications should be monitored and managed by appropriate nursing interventions to minimize the side-ef-fects of complications,and to ensure the safety and efficacy of TPE.
关键词
血浆置换/小儿/并发症/护理Key words
Therapeutic plasma exchange/Pediatric patient/Complication/Nursing intervention引用本文复制引用
出版年
2024
NETL
NSTL
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