急性早幼粒细胞白血病合并DIC行造血干细胞移植的护理

目的1例急性早幼粒细胞白血病合并弥漫性血管内凝血行造血干细胞移植的护理体会，探索造血干细胞移植弥漫性血管内凝血的护理方法。方法针对此病例的疾病特点，改革造血干细胞移植患者锁骨下双腔静脉插管的静脉输注途径，使用留置针穿刺外周静脉。通过对出凝血指标的监测与评估，采取行之有效的护理方法。结果通过对患者出凝血指标异常的严密监测，出血部位得到控制。同时，给予全环境保护隔离，患者成功走出层流室。结论弥漫性血管内凝血，不是一个独立的疾病。该例患者原发病合并DIC，随时有生命危险，因此护理是一个系统工程，只有制订有针对性的护理计划，给予准确的实施，才能保证患者移植成功。

Objective To analyze the procedure of nursing care in one patient with acute promyelocytic leukemia (APL)who developed disseminated intravascular coagulation (DIC)after hematopoietic stem cell transplantation (HSCT).Methods Peripheral venous indwelling needle was used as a pathway of intravenous infusion instead of subclavian central venous catheterization.And coagulation test was monitored and evaluated during HSCT.Results Through the monitoring of coagulation test and environment protective isolation,bleeding was controlled and the patient left laminar flow room successfully.Conclusions DIC is a complicated coagulation disorder.This patient developed life-threatening DIC during HSCT,therefore,for this patient,nursing care is a systematic work.So,only the specified targeted nursing care plans and accurate implementation could ensure the success of HSCT.