随访对肾病综合征患者依从激素联合免疫抑制剂治疗的影响

摘要

目的 探讨随访对原发性肾病综合征依从激素联合免疫抑制剂(CTX)治疗的影响.方法 选取2011年2月至2015年7月于本院行激素联合CTX治疗的原发性肾病综合征患者36例,对其进行电话随访,观察患者是否定期回医院治疗、是否出现并发症、出现并发症是否立即回院治疗,总计9次.结果 36例患者9次回院治疗的百分率依次为100.0％、97.2％、91.7％、88.9％、86.1％、86.1％、88.1％、86.1％、86.1％.第1～9次回访患者大量蛋白尿控制人数逐渐下降,血白蛋白正常值人数增加;血胆固醇正常值人数第1次与第6～9次回访比较,差异有统计学意义(P＜0.01).甘油三脂正常值人数第1次与第9次回访比较,白细胞计数第1次至第6次回访比较,差异有统计学意义(P＜0.05);个别患者出现谷丙转氨酶上升.结论 糖皮质激素联合CTX治疗原发性肾病综合征患者,有延续护理的需求.护士通过电话随访,患者得到心理疏导,积极配合治疗方案,并能及时发现并发症,将并发症的严重程度降低,从而提高疗效,促进康复.%Objective To explore the effect of follow-up on treatment compliance in patients with nephrotic syndrome treated by glucocorticoid and immunosuppressant (CTX).Methods 36 patients with primary nephrotic syndrome treated with glucocorticoid and CTX at our hospital from February,2011 to July,2015 were selected and were followed up by telephone 9 times;whether the patients regularly went back hospital for treatment,whether they got complications,and whether they immediately came back when occurring complications were observed.Results The back-for-treatment percentages of the 9 follow-ups of the 36 patients were 100.0％,97.2％,91.7％,88.9％,86.1％,86.1％,88.1％,86.1％ and 86.1％,respectively.The 9 follow-ups showed that more and more patients got albuminuria and normal blood albumin.The number of patients with normal blood cholesterol of the first follow-up was statistically different from that of those of the 6th to 9th follow-ups (P＜0.01).The number of patients with normal blood triglyceride of the first follow-up was statistically different from that of the 9th follow-up (P＜0.05).The count of WBC of the first follow-up was statistically different from that of the 6th follow-up (P＜0.05).Few patients' alanine aminotransferase level increased.Conclusions Patients with primary nephrotic syndrome treated by glucocorticoid and CTX have the need for continuous nursing care.Through telephone follow-up by nurses,the patients receive psychological counseling and actively cooperate with the treatment,and complications can be found out in time,and severe complications reduced,and the curative effect improved,and the rehabilitation promoted.