关键词: 重症抗NMDAR脑炎；膜式血浆置换；优化护理流程

Abstract: Objective: To analyze the effects of the optimal nursing process for severe anti-NMDAR encephalitis patients receiving membrane plasmapheresis. Methods: Patients with anti-NMDAR encephalitis receiving membrane plasmapheresis in the intensive care unit of the neurology department of a tertiary grade A hospital in Beijing from June 2019 to May 2021 were selected using the convenience sampling method as the research subjects. A total of 12 patients receiving 60 plasma exchange from June 2019 to May 2020 were included as the control group, and another 13 patients receiving 62 plasma exchange from June 2020 to May 2021 as the experimental group. The experimental group was treated with the optimal nursing process, while the control group followed the routine process. The incidence of complications during plasma exchange including increasing involuntary movements, hypotension, clot in the tube and filter membrane rupture and the parameters of plasma exchange such as blood flow rate, plasma extraction ratio, arterial pressure, venous pressure, transmembrane pressure, and the treatment time were compared between the two groups. Results: The incidence of increasing involuntary movements, hypotension in the experimental group was lower than those in the control group (P<0.05), and no differences were observed in other complications. The blood flow rate, plasma extraction ratio and venous pressure in the experimental group were higher than those in the control group (P<0.05), while the arterial pressure and treatment time in the experimental group were lower than those in the control group (P<0.05). Conclusion: The optimal nursing process of membrane plasmapheresis for severe anti-NMDAR encephalitis patients can not only reduce the incidence of complications but also improve the efficiency of plasmapheresis.

Key words: severe anti-NMDAR encephalitis; membrane plasmapheresis; optimal nursing process