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护理研究

TR-350免疫吸附应用于视神经脊髓炎谱系疾病中临床疗效及护理

  • 熊云锦 ,
  • 谷静 ,
  • 龚勇 ,
  • 张寅 ,
  • 周亦伦
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  • 100070 北京,1首都医科大学附属北京天坛医院肾内科
    100068 北京,
    2中国康复研究中心肾内科

收稿日期: 2021-10-08

  修回日期: 2021-12-08

  网络出版日期: 2022-07-12

TR-350 immunoadsorption used in the neuromyelitis optica spectrum disorders: its clinical effects and#br# nursing methods

  • XIONG Yun-Jin ,
  • GU Jing ,
  • GONG Yong ,
  • ZHANG Yin ,
  • ZHOU Yi-Lun
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  • Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China 2Department of Nephrology, China Rehabilitation Research Center, Beijing 100068, China

Received date: 2021-10-08

  Revised date: 2021-12-08

  Online published: 2022-07-12

摘要

目的 总结TR-350免疫吸附治疗国家罕见病——视神经脊髓炎谱系疾病的临床疗效和护理
方法。
方法 收集患者一般情况、治疗过程中的异常反应、设备报警、相关处理及临床结果。 结果 免疫
吸附治疗后患者视力及神经功能均较治疗前有明显改善,扩展残疾状态量表评分(extended disability status scale,EDSS)显著下降(
t=5.404,P =0.005)。水通道蛋白4的免疫球蛋白血清自身抗体水平
显著下降(
t=10.793,P<0.001)。68例次治疗中出现低血压1例次,卡他症状5例次,设备报警14例次。
仅有1例次非计划结束治疗。
结论 免疫吸附效果明显但操作复杂,护士需要严格遵守操作流程,同时
具备分析设备报警原因和处理突发事件的能力,以保证治疗顺利进行。

本文引用格式

熊云锦 , 谷静 , 龚勇 , 张寅 , 周亦伦 . TR-350免疫吸附应用于视神经脊髓炎谱系疾病中临床疗效及护理[J]. 中国血液净化, 2022 , 21(07) : 541 -544 . DOI: 10.3969/j.issn.1671-4091.2022.07.017

Abstract

Objective To summarize the clinical effects and nursing methods of TR-350 immunoadsorption in treatment of the national rare disease, the neuromyelitis optica spectrum disorders. Methods General
situation of the patients, abnormal reactions during treatment, equipment alarm, management and clinical results were collected.
Results Visual acuity and nerve function improved significantly after the immunoadsorption treatment. The extended disability status scale (EDSS) reduced from (5.84 ± 2.16) to (4.46 ± 2.13)
(
t=5.404, P=0.005). The concentration of anti- aquaporin- 4 autoantibody also decreased significantly from
(72.14±24.21)μ/ml to (16.72±6.63)μ/ml (
t =10.793, P0.001). In the 68 cases during treatment, hypotension
occurred in one case, catarrh symptoms in 5 cases, equipment alarm in 14 cases, and unplanned termination of
the treatment in one case.
Conclusions The immunoadsorption effect is obvious but the operation is complicated. Therefore, the operation nurses are required to strictly follow the operation processes, and have the abilities to analyze the cause of equipment alarm and to manage the emergencies to ensure success of the treatment.

参考文献

[1]Hardy T A, Reddel S W, Barnett M H, et al.Atypical inflammatory demyelinating syndromes of the CNS[J].Lancet Neurol, 2016, 15(9):967-981 [2] 中国视神经脊髓炎谱系疾病诊断与治疗指南[J].中国神经免疫学和神经病学杂志, 2016, 23(03):155-166.[J].中国神经免疫学和神经病学杂志, 2016, 23(03):155-166 [3]Sellner J, Boggild M, Clanet M, et al.EFNS guidelines on diagnosis and management of neuromyelitis optica[J].Eur J Neurol, 2010, 17(8):1019-1032 [4]Oji S, Nomura K.Immunoadsorption in neurological disorders[J].Transfus Apher Sci, 2017, 56(5):671-676 [5]Heigl F, Hettich R, Arendt R, et al.Immunoadsorption in steroid-refractory multiple sclerosis: clinical experience in 60 patients[J].Atheroscler Suppl, 2013, 14(1):167-173 [6]K?hler W, Bucka C, Klingel R.A randomized and controlled study comparing immunoadsorption and plasma exchange in myasthenic crisis[J].Journal of Clinical Apheresis, 2011, 26(6):347-355 [7]Michael J Koziolek, Desiree Tampe, Matthias B?hr2, Hassan Dihazi, Klaus Jung, Dirk Fitzner, Reinhard Klingel, Gerhard A Müller and Bernd Kitze: Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis.Journal of Neuroinflammation 2012, 9:80[J].Journal of Neuroinflammation , 2012, 9(9):80-80 [8]Padmanabhan A, Connelly-Smith L, Aqui N, et al.Guidelines on the Use of Therapeutic Apheresis in Clinical Practice - Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Eighth Special Issue[J].J Clin Apher, 2019, 34(3):171-354 [9]Cinar B P, Yorgun Y G.What We Learned from The History of Multiple Sclerosis Measurement: Expanded Disability Status Scale[J].Noro Psikiyatr Ars, 2018, 55(Suppl 1):S69-S75
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