甲乙型血友病患者合并鼻肿物围术期护理

Perioperative nursing of patients with hemophilia A and B complicated with nasal tumor

目的探讨血友病患者行鼻内窥镜手术术前术后护理要点,减少出血,预防并发症的发生。方法总结3名血友病患者(分别为血友病甲型2名及血友病乙型1名),行鼻内窥镜手术围术期的护理体会。结果 3例患者均能如期完成手术,无并发症的发生,顺利出院。结论血友病是一组因遗传性凝血活酶生成障碍引起的出血性疾病,以自发性出血或轻度外伤后出血不止为临床特征,手术往往引起出血不止甚至导致死亡,故一般是手术的禁忌证。术前对于患者及病房做好充分的准备,准确完成凝血因子的预试验,纠正贫血及凝血因子缺乏是非常重要的。术后严密观察出血征象,准确的应用替代疗法,严密观察出血征象,预防DIC及血栓的发生,遵守各项操作规范是患者顺利康复的关键。

Objective To investigate the nursing strategies for patients with haemophilia before or after endoscopic sinus surgery to reduce bleeding and prevent complications.Methods The nursing experience of three patients with haemophilia（two with haemophilia A and one patient with haemophilia B） during perioperative period of nasal endoscopic surgery.Results Three patients completed surgery as scheduled with no complications and they were discharged with recovery.Conclusion Haemophilia is a group of hereditary genetic disorders that impair the body’s ability to control blood clotting or coagulation,which is used to stop bleeding when a blood vessel is broken.Surgery can lead to uncontrollable bleeding and even death.It is generally a contraindication to surgery.Adequate preoperative preparation for patients and ward,accurate pretest of coagulation factor,and correcting anemia and coagulation factor deficiency are very important.Signs of bleeding should be closely monitored,alternative therapies should be precisely applied,DIC and thrombosis should be prevented,and operation procedures should be strictly followed.All of these measures are key to the rehabilitation of patients.