THE OCCURRENCE OF COMPLICATIONS, RELATED INFLUENCING FACTORS AND THEIR NURSING INTERVENTION COUNTERMEASURES IN PATIENTS WITH ANTI-NMDA RECEPTOR ENCEPHALITIS

Ding Lili^{1, 2, 3, 4, *}, Wu Lili^{1, 2, 3, 4}, Zhai Yanping^{1, 2, 3, 4}, Xue Lanping^{1, 2, 3, 4}, Wu Qiong^{1, 2, 3, 4} 

¹Shanxi Bethune Hospital,Taiyuan, 030032, China - ²Shanxi Academy of Medical Sciences, Taiyuan, 030032, China - ³Tongji Shanxi Hospital, Taiyuan, 030032, China - ⁴Third Hospital of Shanxi Medical University, Taiyuan, 030032, China

Objective: To explore the occurrence of complications, related influencing factors and their nursing intervention countermeasures in patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. 

Methods: This study retrospectively analyzed the clinical data of 160 patients with anti-NMDA receptor encephalitis admitted to our hospital from January 2019 to February 2021, and divided the selected patients into the groups with complications (122cases) group and the groups with no complications (38 cases). The two groups of general data were compared, and the statistically significant factors were included in the multivariate analysis, and then a multivariate Logistic regression analysis was performed to analyze the risk factors for the complications of patients with anti-NMDA receptor encephalitis.

Results: Of the 160 patients with anti-NMDA receptor encephalitis cases, 122 had complications with a complication rate of 76.25%. The proportion of patients with epilepsy, cinesipathy, consciousness impairment, autonomic nerve dysfunction, and central hypoventilation was 88.52, 54.92, 73.77, 33.60, and 32.79%, respectively, in the complicated group, higher than the 71.05, 21.05, 18.42, 10.53, and 2.63% in the uncomplicated group. Patients in the complicated group were longer than that of the uncomplicated group (P<0.05); the immunotherapy starting time and the ADL score of complicated group were less than the uncomplicated group (P<0.05). The results of the multivariate Logistic regression analysis showed that the cinesipathy, consciousness impairment, short starting time of immunotherapy, and low ADL score were independent risk factors for the complications of patients with anti-NMDA receptor encephalitis (OR=4.807, 5.360, 2.088, 0.970, P<0.05). 

Conclusion: The risk factors for the occurrence of complications in the patients with anti-NMDA receptor encephalitis may include the cinesipathy, short starting time of immunotherapy, and low ADL score. Thus, targeted treatment and nursing intervention countermeasures for patients can be given clinically according to this situation to reduce the incidence of the complications.