移植物抗宿主病相关性重症干眼症继发角膜溃疡的护理体会

Nursing of a serious case of graft versus host disease complicated with xerophthalmia and corneal ulcer

总结1例白血病行异基因造血干细胞移植术后发生移植物抗宿主病(GVHD)的患者继发重症干眼症及角膜溃疡的护理体验。护理要点是预防继发性感染,干眼症的护理,皮肤及口腔护理,羊膜覆盖术的围手术期护理,同时做好心理疏导,加强健康宣教,预防后期并发症的发生。经过精细治疗及综合护理,治疗18 d后患者出院时眼部症状好转,视力提高,全程无角膜穿孔、高眼压及继发感染等并发症的发生。

This paper summarizes the nursing experience of a case of graft versus host disease（ GVHD） complicated with serious xerophthalmia and corneal ulcer in a case of leukemia following allogene hemopoietic stem transplantation. The most important things in nursing were the prevention of secondary infection,the nursing of xerophthalmia,the body surface,the mouth cavity and perioperative nursing of amniotic membrane covering. At the same time,efforts should be made to relieve strains psychologically and to prevent occurrence of complications at the late stage. After 18 days of careful treatment and comprehensive nursing,eye symptoms were obviously improved and eye sight was increased,without such complications as corneal peroration,high intraocular pressure and secondary infection in the whole course of treatment.