改良Ponticelli方案治疗特发性膜性肾病的疗效观察与护理

目的探讨改良Ponticelli方案治疗中度及高度危险特发性膜性肾病过程疗效与临床护理对策。方法选取在我院肾内科住院治疗的诊断为特发性膜性肾病的患者22例,其危险度分级为中度及重度危险度,或者为既往经激素及环磷酰胺(CTX)治疗无效者,针对这些患者分别予以不同的护理措施。结果完全缓解14例,部分缓解5例,总有效率为86%。患者总体的耐受性较好,但是仍有少数患者有肝损、骨髓抑制及感染情况的发生。结论改良的Ponticelli方案治疗中度及高度危险特发性膜性肾病的疗效比较满意,需要在临床护理工作中密切监测,注意副反应的情况,指导患者配合治疗及做好相应的防范措施。

Clinical effect of revised Ponticelli method for curing idiopathic membranous nephropathy and nursing measures

Objective To explore the curative effect of revised Ponticelli method for curing moderate and serious idiopathic membranous nephropathy patients and the nursing measures.Methods 22 patients with idiopathic membranous nephropathy were given different nursing measures,who were enrolled from January 2002 to February 2005,diagnosed as moderate and serious degree by risk assessment,or no responses to the treatment of hormone and CTX(Cyclophosphamide,Cytoxan).Results Of 22 cases,14(63%)were completely relieved and 5(23%)partly relieved,with a total effective rate of 86%.The patients had much better patience in general,but liver damage,bone marrow suppression and infection occurred in a few of them.Conclusions It is satisfactory that the revised Ponticelli method cure the patients with moderate and serious idiopathic membranous nephropathy.It is necessary to strictly monitor the side effects in clinical nursing,and to guide the patients to adhere to the treatment and take the relevant preventive measures.