上腹部多器官移植术后早期并发急性粒细胞性白血病患者的护理

Nursing of granulocytic leukemia early after abdominal multiple organ transplantation

目的探讨上腹部多器官移植术后并发急性粒细胞性白血病的护理。方法2009年3月至2012年8月共实施8例上腹部多器官移植，1例术后并发急性粒细胞性白血病，总结其临床资料与护理要点。结果本例上腹部多器官移植术后早期并发急性粒细胞白血病的患者术后22d开始发生三系减少，持续4个多月，多次行骨穿刺检查，前2次未发现病因，第3次骨穿刺提示急性粒细胞性白血病，M3型，第4次骨穿刺进行确诊并行基因检测，发现AML。／ETO阳性，确诊后转入血液科经治疗后好转。结论加强病情观察，及时确诊与治疗，做好预防感染、出血与心理护理，是促进患者恢复的关键。

Objective To explore nursing of the patients with acute myelogenous leukemia after upper abdominal cluster transplantation. Methods From March 2009 to August 2012, eight cases of upper abdominal organ cluster transplantation were performed in our center, among whom one suffered from acute myelogenous leukemia after operation. We summarized the clinical data and nursing methods of this case. Results The leukocytes, erythrocytes and platelets decreased 22 days after transplantation and the decreasing continued for more than four months. Four bone marrow biopsies were performed. During the first two biopsies, no definite cause of the blood cells decreasing was found, while the outcome of the third time showed that it was type M3 acute myeloid leukemia and genetic testing at the fourth time showed AML1/ETO was positive. After diagnosis, the patient was shifted to the Department of Hematology and underwent further treatment. Conclusions Close observation, timely diagnosis and treatment, prevention of infection, bleeding and psychological nursing are the keys to promote patients recovery.