nlwxpearo
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 Posted: Sun 20:23, 20 Mar 2011 Post subject: iort3 in acute renal allograft rejection and nursi |
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,[link widoczny dla zalogowanych]
iort3 in acute rejection after renal transplantation and nursing care in
Plant. Renal warm ischemia time for 5 ~ 10min, cold ischemia time of 4 ~ 20h. Lymphocytotoxicity cross-match test 50% by high-sensitivity were 8 cases of preoperative 5 ~ 6 plasmapheresis negative value to PRA. After 31 cases of acute rejection, the average time of occurrence was 6d, accounting for about 15% of the total number of transplants. Use iort356 cases, including 30 males and 26 females, aged 24-58 years old. 53 cases of reversal, the daily urine volume increased to more than 1000ml average time for 9d. Serum creatinine fell to 177tnnol / L below the average time for 16.8d. 3 cases of renal failure who are re-excision surgery recipients, more than 95% reversal rate, to control the role of acute rejection. 2iort3 mechanism of action and the use of 2.1 mechanism iort3 (anti-CD3) for the anti-human T lymphocytes 13 (anti-CI) 3) antigen mouse monoclonal antibody of the sterile liquid, the function is immunosuppression. The anti-rejection by blocking acute renal transplant rejection play a major role in total T cells play a role. 2.2 Usage iort3 the treatment of acute allograft rejection in kidney transplantation is a 14d course of treatment, the use of combination therapy method. (1) 30min prior to intramuscular injection of promethazine with iort3 25nag; (2) to methylprednisolone 200nag 200ml 5% glucose, in use before and after intravenous infusion of 100ml iort3 the fastest speed input, the first reduction drug adverse reactions; (3) iort35nag adding 0.9% Na-C1100ml of rapid intravenous infusion drip completed within 15min requirements, the existing service is used; (4) the use of iort3 aspirin after 30minI = 1 服 0.3g to prevent fever. Treatment in the past, conventional immunosuppressive therapy should be reduced daily dose, stop using cyclosporine. About the Author: Shao Yan-group, female, born in 1971. Bachelor degree, charge nurse and head nurse. Mainly engaged in urology and kidney transplantation care. 3 3.1 Nursing vital signs closely monitored after the 0.5 ~ 6h use iort3 most patients with varying degrees of chills, fever. Should be immediately given intramuscular promethazine 25 Ⅱ 1g indomethacin 25nagI = 1 clothes, while providing physical cooling, if the fever after fever, should be alert to infection. To maintain balance out the amount of 3.2 fatal pulmonary edema is the most serious side effects, but not common and only occurred in patients with fluid overload. Chest before using iort3 X-ray examination,[link widoczny dla zalogowanych], the overloading of water should be adequate dialysis patients with oliguria can be used after iort3 treatment. Such as patients with chest tightness, palpitation, pulse speed up, cough, sputum and other pink foam heart failure symptoms, may take the semi-supine, oxygen, quickly giving lanatoside C 0.4nag, 40 ~ 6o cough furosemide infusion, heart rate,[link widoczny dla zalogowanych], reduce cardiac stress. If symptoms are not alleviated, can be added hydrocortisone 0.9% Nael100ml 100nag intravenously. Excessive urination can be caused by decreased blood volume, electrolyte imbalance, so not too much to use. Maintain the dynamic balance out the amount, if necessary, dialysis. 3.3 Observation of diarrhea,[link widoczny dla zalogowanych], such as patients with mild diarrhea, should be given oral Smecta, 3 / d, each 1 bag. Nurses should observe the extent of diarrhea,[link widoczny dla zalogowanych], nature and quantity, and make perianal skin care. Many transplant centers abroad by iort3 monoclonal antibody to prevent rejection of kidney transplantation in our hospital using the experience and clinical experience shows that after iort3 accelerated acute rejection and acute rejection once the diagnosis should be given to iort3 early treatment can improve the rate of acute rejection reversal , the sooner the better. Especially for PRA> 50% of the high sensitivity recipients, renal transplant recipients once again, delayed recovery of renal function can be enhanced by the early use of immunosuppressive effects iort3 reduce the CSA nephrotoxicity is conducive to the recovery of graft function, reduced acute rejection reaction. 4
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