视神经脊髓炎谱系疾病患者免疫吸附治疗的护理

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目的:总结蛋白A免疫吸附在视神经脊髓炎谱系疾病患者中的应用效果,探讨护理要点。方法:对10例视神经脊髓炎谱系疾病患者行蛋白A免疫吸附治疗,重点做好心理护理,吸附前进行全面评估,确定吸附治疗的处方;吸附治疗时准确预防及处理低血压、血浆分离器的破膜溶血、寒战等各种不良反应;治疗结束后注意预防院内感染、吸附柱再生与保存等。结果:免疫吸附治疗后,10例患者血清中IgG水平、抗体、平均扩展残疾状态量表(EDSS)评分有不同程度下降,血清IgG浓度由治疗前的(6.04 ± 2.77)g/L下降至治疗后的(2.23 ± 1.74)g/L,无严重并发症发生,无一例次免疫吸附操作失败,病情均较前好转。结论:蛋白A免疫吸附治疗视神经脊髓炎谱系疾病安全、有效,规范的评估、操作和护理是达到良好效果的关键。“,”Objective:To explore the application and nursing of protein A immunosorbent in patients with neuromyelitis optica spectrum diseases.Methods:Ten patients with neuromyelitis optica spectrum diseases were treated with protein A immunoadsorption therapy. Psychological nursing was emphasized. Comprehensive evaluation was conducted before adsorption to determine the prescription of adsorption therapy. During adsorption therapy, hypotension, membrane rupture and hemolysis of plasma separator, shivering and other adverse reactions were accurately prevented and treated. After treatment, attention should be paid to the prevention of nosocomial infection, regeneration and preservation of adsorption column.Results:After immunoadsorption therapy, the serum IgG level, antibody and EDSS score of 10 patients decreased to varying degrees. The serum IgG decreased from (6.04±2.77)g/L to (2.23±1.74)g/L. No serious complications occurred, no failure of immunosorbent operation, and the patients′ condition was better than before.Conclusions:Protein A immunosorbent therapy for neuromyelitis optica spectrum diseases is safe and effective. Standardized evaluation, operation and nursing are the key to achieve good results.
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