血浆置换治疗血栓性血小板减少性紫癜的疗效及护理

Efficacy and nursing of plasmapheresis in the treatment of thrombotic thrombocytopenic purpura

目的:观察血浆置换治疗血栓性血小板减少性紫癜患者的临床疗效及其临床护理对治疗的影响。方法:对20例血栓性血小板减少性紫癜患者应用血浆置换治疗,观察患者在血浆置换前后血小板、血红蛋白、血尿素氮、肌酐及间接胆红素的变化情况。在治疗期间,对患者进行耐心细致的护理,评估其生命体征,观察护理对患者的影响。结果:血浆置换治疗后与血浆置换治疗前相比,患者的血清间接胆红素、血尿素氮及肌酐水平显著下降,血小板和血红蛋白显著升高,差异均有统计学意义(P<0.05,P<0.01)。20例患者中,16例好转出院,4例死亡。结论:血浆置换是血栓性血小板减少性紫癜的首选治疗方法,在血浆置换中,加强护理对血浆置换的顺利进行,提高救治成功率和减少并发症等方面起着关键作用。

Objective：To investigate the clinical effect of plasmapheresis to treat the patients sufferred with thrombotic thrombocytopenic purpura and the effect of clinical care for the treatment.Methods：Used plasmapheresis to treat 20 patients sufferred with thrombotic thrombocytopenic purpura and investigated changes of platelet,hemoglobin,blood urea nitrogen,serum creatinine and indirect bilirubin before and after plasmapheresis.Besides,attendanted for the patients carefully,assessed their vital signs and observed the effect of care for them.Results：The levels of indirect bilirubin showed a significant decrease after plasmapheresis compared with that of fore-plasmapheresis,as well as the levels of blood urea nitrogen and serum creatinine,the levels of platelet and hemoglobin showed a noticeable increases,all the differences between them had statistical significance（P＆lt;0.05,P＆lt;0.01）.16 patients of them were cured well and 4 cases were dead.Conclusions：Plasmapheresis is the first selection in the treatment for thrombotic thrombocytopenic purpura,in plasmapheresis,strengthen the nursing of plasma exchange smoothly,plays a key role in improving the cure rate and reducing the complications.