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 disabili-ty 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.

目的 通过对维持性血液透析患者的横断面研究,探讨患者焦虑状态和不依从性的患病率及两者的相关性.方法 选取2019年1-7月在首都医科大学附属北京天坛医院血液净化中心接受维持性血液透析治疗的患者,应用Zung氏焦虑自评量表(self-rating anxiety scale,SAS)对患者进行测评,收集患者透析间期体质量增长/干体质量(％)、透析前血钾等数据,分析液体限制不依从性、饮食钾限制不依从性、总体不依从性与焦虑状态之间的相关性.结果 最终纳入的82例患者中有焦虑状态者占15.9％(13/82),液体限制不依从者占14.6％(12/82),饮食钾限制不依从者占18.3％(15/82),总体不依从者占29.3％(24/82).焦虑状态患者与非焦虑状态患者相比,液体限制不依从性(38.5％比10.1％,P = 0.019)及总体不依从性(53.8％比24.6％,P = 0.047)比例均明显偏高.多因素logistics回归分析显示,焦虑状态是液体限制不依从性(OR = 5.71,95％CI:1.07～30.38)的独立影响因素.结论 维持性血液透析患者中焦虑状态、不依从性并不少见;焦虑状态是液体限制不依从性的独立影响因素.关注并改善患者精神状态,有潜在临床意义.

[目的]探讨运用五星教学模式对透析病人陪护者进行高钾血症防治知识的培训效果。[方法]应用五星教学模式,以聚焦问题为宗旨,通过激活旧知、论证新知、应用新知和融会贯通4个环节对102例维持性血液透析病人的陪护者进行高钾血症防治知识的培训,观察培训前后病人陪护者对高钾血症相关知识的知晓情况以及培训后1个月、2个月、3个月病人食物钾摄入量、透析前血钾水平及高血钾症发生率。[结果]培训3个月后,病人对高钾血症相关知识知晓率提高;饮食钾摄入量由（61.38±9.16）mmol/d下降至（44.68±7.28）mmol/d,透析前血钾由（6.21±0.28）mmol/L下降至（5.32±0.37）mmol/L,高钾血症发生率由32%下降至14%。[结论]运用五星教学模式对陪护者进行高钾血症防治知识的培训,可以有效降低维持性血液透析病人的血钾水平,减少高钾血症的发生。

BACKGROUND:Dialysis is imperative for patients with end-stage renal disease (ESRD); however, compliance ensures its efficacy. Nursing intervention has been considered to improve compliance. This meta-analysis is aimed at exploring the effects of nursing intervention on dialysis compliance.METHODS:A search was performed in the PubMed, Cochrane, and Embase databases for relevant original research articles. Studies were included or excluded based on the simultaneous consideration of quality as ranked by Jadad score and the compliance with predefined selection criteria.RESULTS:A total of 817 participants were included. The results showed that nursing intervention led to significantly higher compliance with dialysis than in standard care. A pilot analysis evidenced that different intervention strategies, including educational, cognitive, and behavioral approaches, had limited effects on dialysis compliance.CONCLUSION:Nursing intervention is beneficial for raising dialysis compliance, providing evidence of the need to strengthen nursing care for ESRD patients administered with dialysis in daily clinical practice.

Objective To investigate the effect of Ultra Control Mode in patients with hemodiafiltration.Methods From November 2010 to April 2011,44 maintenance hemodialysis patients were recruited to receive hemodiafiltration once per 2 weeks.The volume control mode and Ultra Control(pressure control) Mode were used in 6 hemodiafiltraiton sessions respectively.The routine volume of displacement liquid was monitored and the incidence of transmembrane pressure(TMP) warning was recorded.Results The volume of displacement liquid was significantly higher in Ultra Control Mode with than in volume control mode[(15.16±2.34)L vs(14.22±1.83)L,P0.01].No TMP warning was observed in Ultra Control Mode.Conclusion Ultra Control Mode during hemodiafiltration can increase the volume of displacement liquid without TMP warning,thus deserves further popularization.

Objective To investigate the effects of transparent dressing on the patients with stage II pressure ulcer.Methods Thirty patients with stage Ⅱ bedsore(the blister period) were randomly divided into 2 groups:observation group(n=15) and control group(n=15).Patients in Group A received traditional treatment and those in the observation group were treated with 3M transparent dressing.Results The treatment time and cost of the observation group were both significantly lower than those of the control group.The incidences of infection were similar between the 2 groups.Conclusion Transparent dressing has good effects on patients with stage Ⅱ pressure ulcer.