肾病综合征患儿发生肾上腺危象的相关危险因素及护理干预措施
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摘要
目的探讨肾病综合征患儿发生肾上腺危象的相关危险因素,加强护理干预措施,提高早期识别率,降低死亡率。方法选取我科自2012年—2017年收治的215例肾病综合征患儿,其中21例并发肾上腺危象的患儿的临床资料,回顾性分析两组间患儿的临床资料基线及实验室指标,行Logistic回归分析肾病综合征患儿发生肾上腺危象的相关危险因素。结果结果:恶心、呕吐、腹痛、疲倦、无尿、肤冷、钠离子低、钾离子高、血浆纤维蛋白原、白细胞、尿蛋白等是肾病综合征患儿中发生肾上腺危象中均有统计学意义,而低钠、高钾、毛细血管充盈试验时间延长、白细胞升高是肾病综合征患儿发生肾上腺危象的危险因素。结论尽早识别、及时护理干预可减少肾上腺危象的并发症、降低死亡率。
Objective To explore the related risk factors of adrenal crisis in children with nephrotic syndrome,strengthen nursing intervention,improve the early recognition rate and reduce the mortality. Methods The clinical data of215 children with nephrotic syndrome in our department from 2012-2017,including 21 cases of adrenal crisis,were analyzed retrospectively. The baseline and laboratory indexes of the clinical data of the two groups were analyzed retrospectively.The risk factors related to the adrenal crisis in children with nephrotic syndrome were analyzed by Logistic regression. Results Nausea,vomiting,abdominal pain,tiredness,no urine,skin cold,low sodium ion,high potassium ion,FIB,white blood cell and urine protein were statistically significant in the adrenal crisis in children with nephrotic syndrome,while low sodium,high potassium,CRT lengthening,and white blood cell rise are the independent risk factors for adrenal crisis in children with nephrotic syndrome. Conclusion Early identification and timely nursing intervention can reduce the complications and mortality of adrenal crisis.
Objective To explore the related risk factors of adrenal crisis in children with nephrotic syndrome,strengthen nursing intervention,improve the early recognition rate and reduce the mortality. Methods The clinical data of215 children with nephrotic syndrome in our department from 2012-2017,including 21 cases of adrenal crisis,were analyzed retrospectively. The baseline and laboratory indexes of the clinical data of the two groups were analyzed retrospectively.The risk factors related to the adrenal crisis in children with nephrotic syndrome were analyzed by Logistic regression. Results Nausea,vomiting,abdominal pain,tiredness,no urine,skin cold,low sodium ion,high potassium ion,FIB,white blood cell and urine protein were statistically significant in the adrenal crisis in children with nephrotic syndrome,while low sodium,high potassium,CRT lengthening,and white blood cell rise are the independent risk factors for adrenal crisis in children with nephrotic syndrome. Conclusion Early identification and timely nursing intervention can reduce the complications and mortality of adrenal crisis.
引文
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[13]张秀琼,吴怀巧,张素梅.高血压肾病血压的护理干预[J].现代医院,2014,04(14):66-67
[14]李毓雯,罗小平.儿童肾上腺危象的诊断与治疗[J].中国实用儿科杂志,2006,21(11):808-810.
[2]郭树彬.肾上腺危象的诊治[J].中国临床医生,2011,39(2):6-8.
[3]邹百仓,董蕾,马明弦,等.肾上腺危象诊治1例并文献复习[J].临床荟萃,2007,22(12):898-899.
[4]KAZUEO,KZORUN,SATORUS,etal.Riskfactorsforadrenal crisisinpatients with adrenal insufficiency[J].Endocrine Journal,2003,50(6):745-752.
[5]CONELIUS CC,NOEL C,PETER JK,et al.Addison disease in patients treated with glucocorticoid therapy[J].Arch Intern Mednol,1997,157:456-458.
[6]BHATTACHARYYA A,MACDONALD D,LAKBDAR AA.Acute adrenocortical efi-sis:three different[J].Int Clin Pract,2001,55:141-144.
[7]SHULMANDI,PALMER T M R,KENP S F.Adrenalinsufficiency:still a cause of morbidity and death in childhood[J].Pediatrics,2007,119(2):484-494.
[8]陈乐天.医源性肾上腺危象的临床分析[J].中华临床医学杂志,2006,7(8):29.
[9]杨界云:肾病综合并发症治疗的几个问题[J].实用儿科杂志1989;4(3):121-123。
[10]孟萌.整体护理在肾病综合征患者中的应用及效果观察[J].齐鲁护理杂志,2012,18:24-25.
[11]王宝琳.小儿肾脏病学[M].北京:人民卫生出版社北京,1983:184-185.
[12]潘丽雯,关曼芸,肖海英.优质护理干预对糖尿病肾病的临床应用价值[J].现代医院,2015,15(6):102-103,105.
[13]张秀琼,吴怀巧,张素梅.高血压肾病血压的护理干预[J].现代医院,2014,04(14):66-67
[14]李毓雯,罗小平.儿童肾上腺危象的诊断与治疗[J].中国实用儿科杂志,2006,21(11):808-810.