摘要
目的探讨艾滋病(AIDS)合并新型隐球菌性脑膜炎(CNM)死亡的危险因素,并结合临床诊断与治疗过程探索护理对策,为优化临床诊治及护理干预措施、降低病死率提供参考。方法选择2012年1月至2020年12月南宁市第四人民医院收治的AIDS合并CNM死亡患者57例,对其临床及护理相关资料进行回顾性分析,包括HIV感染途径、临床表现、实验室检查结果和并发症等。结果57例AIDS患者住院1个月内死亡24例(42.1%),生存时间中位数14d。头痛49例(86.0%),发热40例(70.2%),呕吐36例(63.2%),意识障碍20例(35.1%)和视力下降13例(22.8%)。合并肺部感染53例(93.0%)。脑脊液压力升高(≥180mmH_(2)O)48例(84.2%),血红蛋白含量减低(<90g/L)31例(54.4%),血钾浓度降低(<3.5mmol/L)53例(93.0%)。CD4^(+)T淋巴细胞计数降低(<100个/μl)56例(98.2%)。结论AIDS合并CNM患者临床表现复杂,意识障碍、合并肺部感染、脑脊液压力升高、低血钾和低CD4^(+)T淋巴细胞计数是本病死亡的重要临床表现。医护人员应提高对本病的认识,加强监测和护理,及时发现和处理各种并发症,从而降低病死率。
Objective To explore the risk factors of acquired immune deficiency syndrome(AIDS)complicated with cryptococcal meningitis(CNM)death,and combined exploring nursing countermeasures in the process of clinical diagnosis and treatment,for the optimization of clinical diagnosis and treatment and nursing intervention measures to improve the reference to reduce the mortality.Method From January 2012 to December 2020,57 AIDS patients with CNM deaths were admitted,and their clinical and nursing-related data were retrospectively analyzed,including HIV infection pathways,clinical manifestations,complications,and laboratory test result.Result Among 57 AIDS patients,24 cases(42.1%)died within 1 month of hospitalization,and the median death time was 14 days.There were 49 cases of headache(86.0%),40 cases of fever(70.2%),36 cases(63.2%)of vomiting,20 cases(35.1%)of consciousness disorder and 13 cases(22.8%)of vision loss.Fifty-three cases(93.0%)complicated with lung infection.There was increased cerebrospinal fluid pressure(≥180mmH_(2)O)in 48 cases(84.2%),decreased hemoglobin content(<90g/L)in 31 cases(54.4%),and decreased blood potassium concentration (<3.5mmol/L) in 53 cases (93.0%). Decreased count of CD4^(+)T lymphocytes (<100cells/μl) was detected in 56 cases (98.2%). Conclusion The clinical manifestations of AIDS patients with CNM are complex, and the disturbance of consciousness, pulmonary infection, cerebrospinal fluid pressure, low blood potassium and low CD4^(+)T lymphocyte count are important clinical manifestations for death of AIDS patients with CNM. Medical staff should improve the understanding of this disease, strengthen monitoring and care, and detect and deal with various complications in time, so as to reduce the mortality rate.
作者
黄利雪
李莎
李倩
滕小雁
李洁英
韦彩云
吴锋耀
Huang Lixue;Li Sha;Li Qian;Teng Xiaoyan;Li Jieying;Wei Caiyun;Wu Fengyao(Department of Internal Medicine,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center,Nanning Infectious Disease Hospital Affiliated to Guangxi Medical University,Nanning 530023,China;Department of Nursing,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center,Nanning Infectious Disease Hospital Affiliated to Guangxi Medical University,Nanning 530023,China;Department of Party Office,the Fourth People's Hospital of Nanning,Guangxi AIDS Clinical Treatment Center,Nanning Infectious Disease Hospital Affiliated to Guangxi Medical University,Nanning 530023,China)
出处
《新发传染病电子杂志》
2022年第1期56-59,共4页
Electronic Journal of Emerging Infectious Diseases
基金
南宁市科学技术局重大专项(20193008)
广西卫生健康委员会自筹经费科研项目(Z20201108)。
关键词
艾滋病
新型隐球菌性脑膜炎
危险因素
护理
Acquired immune deficiency syndrome
Cryptococcus neoformans meningitis
Risk factors
Nursing
