新型移植诱导剂阿来佐单抗临床应用中的护理程序

将阿来佐单抗成功应用于尸体肾移植前免疫诱导21例、单纯胰岛细胞移植围手术期免疫诱导7例、尸体肾移植联合胰岛细胞和间充质干细胞移植前免疫诱导1例.通过严格、及时、正确的病房管理,肺部、会阴部、皮肤、饮食、心理等护理,以上病例术前用药过程顺利,未出现不良反应者11例占38%,高血压者18例占62%,寒战3例占10%,高热3例占10%,支气管痉挛1例占3%.经应对症处理后,29例患者全部病情平稳,完成用药计划且术后均未发生急件排斥反应,出院后随访最长时间为2年,最短时间为6个月,结果亦未有移植物排斥指征.但是,阿来佐单抗在移植前免疫诱导的长远疗效,还有待通过患者长期随访,以进一步观察阿来佐单抗的诱导治疗效果,并观察长期T淋巴细胞减少所致的相关不良作用.

Nursing management with alemtuzumab for prevention of graft rejection

Alemtuzumab (Campath) was successfully injected in 21 kidney transplant patients,7 islet transplant patients and 1 simultaneous kidney and islet transplant patient for either prevention or treatment of graft rejection.Prophylactic administration was successfully completed in all patients without discontinuation.Adverse events were not observed in 11 patients (38%),but hypertension in 18 patients (62%),shivering in 3 patients (10.3%),high fever in 3 patients (10.3%),and bronchospasm in 1 patient (3%),respectively.All complications alleviated after proper therapy.During the prophylactic administration of alemtuzumab,strict,timely and proper ward-management was needed.Care for lung,perineum,skin,diet and psychological nursing were necessary.Neither graft acute rejection nor graft chronic rejection episode occurred in all patients during 6 months to 2 years follow-up.Therefore,long term effects of Alamtuzumab and consequences of lymphocytopenia need further observation.