血栓性血小板减少性紫癜患者血浆置换的特点及护理

Plasma Exchange in Treatment of Patents with Thrombotic Thrombocytopenic Purpura and Care of the Patients

总结血栓性血小板减少性紫癜(TTP)患者血浆置换的特点及其护理要点。回顾性分析11例TTP患者血浆置换过程中患者的心理特点、技术操作要点、心血管系统并发症的发生、出血情况、神经系统异常对血浆置换的影响。认为对TTP患者进行健康教育有助于血浆置换顺利进行;在血小板计数低的情况下,加强病情观察,合理使用抗凝剂,血浆置换过程不会明显加重出血;置换过程采用床边CRRT机器进行,并加强对患者血压变化、神经症状的监测,以防止出现血流动力学的改变而影响血浆置换的顺利进行。

The authors summarized the characteristics of plasma exchange in treatment of patents with thrombotic thrombocytopenic purpura （TTP） as well as their care measures by retrospectively analyzing the mental features, operating measures, cardiovascular complications and hemorrhage and abnormality in nervous system in 11 TTP patients during plasma exchange. They believed health education helped the smooth plasma exchange, observation needed strengthening and anticoagulants reasonable use in case of lower counting of blood platelets to avoid deteriorated hemorrhage during exchange, bed-side CRRT device was used at exchange, the monitoring over changes in blood pressure and nervous symptoms was intensified to prevent the changes in angiodynamics haemodynamics, which may affect the smooth exchange.