慢加急性乙型肝炎肝衰竭患者行异体骨髓间充质干细胞移植的护理-论文.pdf

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1、中国实用护理杂志2014年6月21日第30卷第l8期ChinJPracNurs．June212014，v01．30，No．18·1··科研之窗·慢加急性乙型肝炎肝衰竭患者行异体骨髓间充质干细胞移植的护理陈菲菲杨丽华陈苑莉陈俊峰蔡银科【摘要】目的观察经外周静脉异体骨髓间充质干细胞移植治疗慢加急性乙型肝炎肝衰竭的疗效及护理特点。方法经外周静脉行异体骨髓间充质干细胞移植术治疗45例慢加急性乙型肝炎肝衰竭的患者，以46例单纯内科综合治疗的患者为对照，分析l2周患者存活情况和肝功能的变化，并针对手术不同时期进行整体护理。结果患者的l2周存活率为75

2、．6％(34／45)，高于对照组的52．2％(24／46)，干细胞治疗胆红素和凝血功能有明显改善。结论异体骨髓间充质干细胞移植可提高慢加急性乙型肝炎肝衰竭患者的生存率，术前的心理护理，熟练的技术操作，术后的精心护理和病情观察有利于移植后患者的康复。【关键词】异体骨髓干细胞移植；慢加急性肝衰竭；乙型肝炎；护理NursingstudyonallogenicbonemarrowmesenchymalstemceHtransplantationinpafien~withHBVrelatedacute-on-chronicHverfailureCh

3、enlee，YangLihua，ChenYuanli，ChenJunfeng,CaiYinke*．*DepartmentofInfectiousDiseases，theThirdAffiliatedHospitalofSunYat-senUniversity，Guangzhou510630，ChinaCorrespondingauthor：CaiYinke，Email：mH87560438@163．com【Abstract】ObjectiveOurresearchaimedtoinvestigatetheeficacyandthenurs

4、ingcharacteristicsofanogenicbonemallOWmesenchymalstemcell(BM-MSCs)transplantationinHBVrelatedacute—on-chronicliverfailure(ACLF)patients．MethodsAtotalof91HBVrelatedACLFpatientswereenrolled，amongwhom45patientsreceivedallogenicBM·MSCstransplantationviaperipheralveinandother4

5、6patientsreceivedmedicaltreatmentonly．Weassessedthe12一weeksurvivalratesandthevariationofmodelforendliverdisease(MELD)score．Besides，weadministratedcomprehensivenursingforthesepatientsindiferentstagesofthetransplantation．ResultsThecumulatedsurvivalofpatientsreceivedBM-MSCtr

6、ansplanta-tionwas75．6％，whichwashigherthanthecontrolgroup(54．5％)．TheleveloftotalbilirubinandIntema—tionalNormalizedRatio(INR)hadgreatlyimproved．41of45patientspassedthroughperioperativeperiodsafely，withoutanysevereadverseevents．11patientsdiedduetoexacerbationofliverfailure，

7、amongwhom3happenedinperioperativeperiod．Butnonewasrelatedwiththeoperation．ConclusionsAllogenicBM·MSCstransplantationcanimprovethesurvivalrateofHBVrelatedACLFpatients．Thepsychologicalnursingpre-operation，skilledoperation，intensivecareandobservationpostoperationwerebenefici

8、altothepatientsrecoveryaftertransplantation．【Keywords]Allogenicbonemarrowstemcelltransplantation