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。
周佳
,
张慧
,
周清
,
赵蕊
,
沈霞
,
刘帆
,
沈茜
,
徐虹
,
方晓燕
. 血浆置换在小儿肾脏风湿疾病治疗的应用及护理[J]. 中国血液净化, 2024
, 23(04)
: 313
-316
.
DOI: 10.3969/j.issn.1671-4091.2024.04.016
Objective To analyze the application of therapeutic plasma exchange (TPE) and its complications in pediatric renal rheumatic diseases, and to explore the relevant nursing strategies. Methods The children undergoing TPE at the Department of Nephrology and Rheumatology, Fudan University Children's Hospital 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 Complications occurred in the 28 times of TPE for the 9 patients, including allergic reactions 9 times (32.1%), hypocalcemia 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-effects of complications, and to ensure the safety and efficacy of TPE.
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