行与未行HAART的艾滋病病人的死亡原因分析

目的分析进行和未进行高效抗反转录病毒治疗（HAART）的艾滋病（AIDS）病人的死亡原因,探索护理对策。方法回顾性分析1996-2009年北京地坛医院住院治疗的AIDS死亡病例的临床资料,并对进行和未进行HAART者的死亡原因、免疫状态和病程等进行比较分析。结果 1996-2009年共有66例AIDS病人住院治疗,未行HAART的48例病人的死亡原因为：44例（91.6%）死于艾滋病相关机会性感染,2例（4.2%）死于消耗综合征和非艾滋病相关性疾病,其中1例（2.1%）为失血性休克;18例行HAART的病人中,死于艾滋病相关机会性感染7例（38.9%）,死于乳酸酸中毒、慢性重型肝炎所致的肝衰竭各3例（16.7%）,死于消化道出血所致的失血性休克2例（11.1%）,死于消耗综合征、脑梗死、极重度贫血/粒细胞缺乏症各1例（5.5%）。结论 HAART治疗后,AIDS病人临床相发生了明显变化,在临床实践中应注意观察并采取相应措施。在治疗过程中的护理,要提高病人服药依从性,并注意监测抗病毒药物的不良反应,做到早发现、早治疗。

An analysis of the causes of death among AIDS patients before and after HAART and relevant nursing care

Objective To analyze the causes of death among AIDS patients before and after HAART and explore relevant nursing care.Methods The clinical data of 68 dead AIDS patients who had been hospitalized in Beijing Ditan Hospital from 1996 to 2009 were retrospectively analyzed,which included HAART,opportunistic infection,immunity and the causes of death.The courses of disease progression were compared between the patients receiving HAART and those without HAART.Results A total of 66 patients were hospitalized in the hospital in 1996-2009.The causes of death of the patients who did not receive HAART were opportunistic infection（46 cases,95.8%）,wasting syndrome（2 cases,4.2%） and hemorrhagic shock（1 case,3.4%）,while the causes of death of those who received HAART were ：AIDS associated opportunistic infection（7 cases,38.9%）,wasting syndrome（1 case,5.6%）,lactic acidosis（3 cases,16.7%） and liver failure due to severe hepatitis（3 cases,16.7%）.Conclusions The clinical manifestations of AIDS have changed significantly after HAART,close observation and proper management should be provided to the patients,and meticulous nursing care is essential to improve patients＇ compliance and monitor possible adverse reactions of ARV drugs.