多发性骨髓瘤伴心肌淀粉样变患者突发意识丧失的急救护理

doi:10.3761/j.issn.2096-7446.2022.04.008

中华急危重症护理杂志 ›› 2022, Vol. 3 ›› Issue (4): 335-337.doi: 10.3761/j.issn.2096-7446.2022.04.008

多发性骨髓瘤伴心肌淀粉样变患者突发意识丧失的急救护理

周燕, 钱丽娅, 陈睿, 韩帆

杭州市浙江大学医学院附属邵逸夫医院血液内科

收稿日期:2022-01-05 出版日期:2022-07-10 发布日期:2022-07-07
作者简介:周燕：女,硕士,主管护师,护士长,E-mail：zhouy2@srrsh.com

Identification and emergency care of sudden loss of consciousness in patients with multiple myeloma complicated with myocardial amyloidosis

ZHOU Yan, QIAN Liya, CHEN Rui, HAN Fan

Received:2022-01-05 Online:2022-07-10 Published:2022-07-07

摘要/Abstract

摘要： 总结7例多发性骨髓瘤伴心肌淀粉样变患者突发意识丧失的高风险因素有效识别和急救护理经验。针对该类患者起病隐匿、临床表现缺乏特异性、病情变化快、病死率高等临床特点,采取早期识别高风险因素、快速识别恶性心律失常、有效抢救配合、正确实施经皮体外起搏等措施,成功抢救6例患者,化疗后出院,随访恢复良好。

关键词: 多发性骨髓瘤, 心肌淀粉样变, 意识丧失, 急症护理

Abstract: To summarize the effective identification of high risk factors and emergency care experience for sudden loss of consciousness in 7 patients with multiple myeloma with myocardial amyloidosis. For the onset concealment,clinical specificity,rapid changes,high fatality characteristics of these patients,early identification of high risk factors,rapid identification of malignant arrhythmia,effective rescue cooperation,correct implementation of percutaneous in vitro pacing were implemented. Six patients were successful rescued and discharged after chemotherapy,and recovery were good during follow-up.

Key words: Multiple Myeloma, Myocardial Amyloidosis, Unconsciousness, Emergency Nursing

周燕, 钱丽娅, 陈睿, 韩帆. 多发性骨髓瘤伴心肌淀粉样变患者突发意识丧失的急救护理[J]. 中华急危重症护理杂志, 2022, 3(4): 335-337.

ZHOU Yan, QIAN Liya, CHEN Rui, HAN Fan. Identification and emergency care of sudden loss of consciousness in patients with multiple myeloma complicated with myocardial amyloidosis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(4): 335-337.

参考文献

[1] Michels TC,Petersen KE.Multiple myeloma:diagnosis and treatment[J]. Am Fam Physician,2017,95(6):373-383.
[2] 中国医师协会血液科医师分会,中华医学会血液学分会,中国医师协会多发性骨髓瘤专业委员会. 中国多发性骨髓瘤诊治指南(2017年修订)[J]. 中华内科杂志,2017,56(11):866-870.
Hematologist Branch of Chinese Medical Doctor Association,Hematology Committee of Chinese Medical Association,Multiple Myeloma Professional Committee of Chinese Medical Doctor Association. The guidelines for the diagnosis and management of multiple myeloma in China(2017 revision)[J]. Chin J Intern Med,2017,56(11):866-870.
[3] Plummer C,Driessen C,Szabo Z,et al.Management of cardiovascular risk in patients with multiple myeloma[J]. Blood Cancer J,2019,9(3):26.
[4] 冀晋,方理刚,方全,等. 心肌淀粉样变104例临床分析[J]. 中华心力衰竭和心肌病杂志(中英文),2017(2):98-103.
Ji J,Fang LG,Fang Q,et al.Clinical analysis of 104 cases with cardiac amyloidosis[J]. Chin J Heart Fall & Cardiomyopathy,2017(2):98-103.
[5] 邱惠,沈爱东,孙志军,等. 8例多发性骨髓瘤致心肌淀粉样变性临床特点分析[J]. 中国心血管杂志,2018,23(3):219-223.
Qiu H,Shen AD,Sun ZJ,et al.Clinical characteristics of 8 patients with cardiac amyloidosis caused by multiple myeloma[J]. Chin J Cardiovasc Med,2018,23(3):219-223.
[6] 吴茂源,许传芬,许岩,ICU心脏淀粉样变性患者的临床特征和预后因素研究[J]. 中国急救医学,2019,39(5):446-451.
Wu MY,Xu CF,Xu Y,Study on clinical characteristics and prognostic factors of ICU patients with cardiac amyloidosis[J]. Chin J Emerg Med,2019,39(5):446-451.
[7] 李光照,姜正明,户富栋,等. 多发性骨髓瘤致心脏淀粉样变的临床特点分析[J]. 中国实用医刊,2020,6(12):22-25.
Li GZ,Jiang ZM,Hu FD,et al.Clinical analysis of cardiac amyloidosis caused by multiple myeloma[J]. Chin J Clin Med,2020,6(12):22-25.
[8] 申曼,黄仲夏,李新,等. 硼替佐米治疗新诊断多发性骨髓瘤期间心脏不良事件的影响因素及其对生存时间影响的真实世界研究[J]. 中国全科医学,2021,24(2):210-218.
Shen M,Huang ZX,Li X,et al.Associated factors and outcome of cardiac adverse events in newly diagnosed multiple myeloma patients with bortezomib:a real-world study[J]. Chin Gen Pract,2021,24(2):210-218.
[9] 李诗文,刘卓刚,胡荣. 多发性骨髓瘤相关心血管事件研究进展[J]. 中国实验血液学杂志,2019,27(6):2035-2038.
Li SW,Liu ZG,Hu R.Research progress of multiple myeloma related cardiovascular events[J]. Chin J Experi Hematol,2019,27(6):2035-2038.
[10] 刘平,李晚泉,黄雪兰,等. 胸外按压联合应用经皮体外起搏的应用研究[J]. 中国医药导报,2010,7(15):33-34.
Liu P,Li WQ,Huang XL,et al.Application of external chest compression combined with percutaneous application of pacing in vitro[J]. China Med Her,2010,7(15);33-34.
[11] 中国研究型医院学会护理分会项目组. 中等长度静脉导管临床应用专家共识[J]. 中华护理杂志,2020,55(S2):43-50.
Project Team of Nursing Branch of Chinese Research Hospital Association. Expert consensus on the clinical application of medium length intravenous catheter[J]. Chin J Nurs,2020,55(S2):43-50.

[1]	羊木英, 范文琪, 胡汉. 维持性血液透析患者透析中脑出血的早期识别与急救护理[J]. 中华急危重症护理杂志, 2026, 7(6): 704-706.
[2]	丁幼芽, 王飒, 闫丹萍, 周帅帅, 武作家, 王钰炜. 甲醇中毒致顽固性低钾血症患者的护理[J]. 中华急危重症护理杂志, 2026, 7(4): 447-449.
[3]	陈兆斐, 王薇, 翟振国. 静脉血栓栓塞症一体化防治策略的实施与质量控制[J]. 中华急危重症护理杂志, 2026, 7(3): 274-278.
[4]	于雅诺, 宋雨航, 高凌婕, 李晓波. 临床决策支持系统在急诊分诊管理中应用的范围综述[J]. 中华急危重症护理杂志, 2026, 7(3): 306-311.
[5]	高彬炳, 王飒, 周帅帅, 张玉坤, 王钰炜. 肺栓塞致心搏骤停患者并发肝血管瘤破裂的急救护理[J]. 中华急危重症护理杂志, 2026, 7(3): 315-318.
[6]	夏致远, 何佳, 王黎醒, 石义容, 杨敏, 王荀, 黄燕梅, 李志艳, 张利. 钩吻群体中毒患者跨机构协作及急救护理[J]. 中华急危重症护理杂志, 2026, 7(1): 77-79.
[7]	杨晓华, 孙婷, 王萍, 姚梅琪. 1例高龄患者因水摄入过量致重度低钠血症的急救与警示[J]. 中华急危重症护理杂志, 2025, 6(8): 995-997.
[8]	司童, 周勇, 王爽. 从医生视角看基于案例的过度水化所致神经系统症状的临床特征与防范[J]. 中华急危重症护理杂志, 2025, 6(8): 998-1002.
[9]	周惠云, 罗飞翔, 慎斐. 急性呼吸窘迫综合征早产儿体外膜肺氧合下行俯卧位通气的护理[J]. 中华急危重症护理杂志, 2025, 6(7): 826-829.
[10]	陈鹏. 呼气末二氧化碳监测在心肺复苏患者中应用的研究进展[J]. 中华急危重症护理杂志, 2025, 6(7): 891-896.
[11]	周军, 陈阮, 诸纪华. 难治性支原体肺炎患儿并发右心室血栓与肺栓塞的护理[J]. 中华急危重症护理杂志, 2025, 6(6): 700-703.
[12]	王飒, 闫丹萍, 刘亚洁, 周帅帅, 王美玲, 林高兴, 许书荣, 周光居, 王钰炜. 急诊心搏骤停患者低灌流期间神经系统监测与护理管理实践[J]. 中华急危重症护理杂志, 2025, 6(6): 713-718.
[13]	陆殿霞, 梅义菊, 陈雨, 陈玉玥, 王吉, 曹雪婷, 张劲松. 南方地区醉酒后野外夜宿致严重冻伤患者的护理[J]. 中华急危重症护理杂志, 2025, 6(5): 573-575.
[14]	姚晓月, 卢伟松, 张兰兰, 潘银芝, 沈卫娣, 沈安妮, 杨旻斐. 阿尔茨海默病患者高处坠落引发激越行为的护理[J]. 中华急危重症护理杂志, 2025, 6(4): 459-461.
[15]	李春玲, 徐淼, 杨冬梅, 冯达应. 妊娠中期自发性冠状动脉夹层致心肌梗死患者的急救护理[J]. 中华急危重症护理杂志, 2025, 6(3): 332-334.

多发性骨髓瘤伴心肌淀粉样变患者突发意识丧失的急救护理

Identification and emergency care of sudden loss of consciousness in patients with multiple myeloma complicated with myocardial amyloidosis

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价