1例淋巴瘤患者突发自身免疫性溶血后继发急性皮肤衰竭的护理体会

Nursing experience of acute skin failure secondary to sudden autoimmune hemolytic anemia in a patient with lymphoma

血液病患者突发自身免疫性溶血导致全身组织器官缺血、缺氧进而发生急性皮肤衰竭的案例较为罕见。该研究总结1例淋巴瘤患者突发自身免疫性溶血后双足跟发生急性皮肤衰竭的护理经验:使用硅酮泡沫敷料保护双侧足跟部,使用软枕或减压垫垫于双小腿使双足跟“漂浮”,使用赛肤润涂抹骨隆突处,定时评估皮肤情况,营养支持,早期康复等。通过精心护理,患者病情平稳,转回移植病房继续治疗。该文丰富了血液病重症患者的急性皮肤衰竭的鉴别和护理经验。

To summarize the nursing experience of a patient with lymphoma who developed acute skin failure on both heel of a lymphoma patient after actue autoimmune hemolysis.After reviewing the literature and analyzing the risk factors,location,shape and color of acute skin failure,the nursing measures were taken,including using silicone foam dressing to protect the heel on both sides,using soft pillow or pressure relief pad to make the heel“float”on the legs,applying skin moisturizing on the bone protuberances,regular assessment of the skin condition,nutritional support,early rehabilitation and health education,etc.Under the premise of ensuring the life safety of patients,the further deterioration of acute skin failure has effectively intervened.Through careful nursing,the patients condition was stable and he was transferred back to the transplant ward.At the same time,this case also provides experience for the identification and nursing of acute skin failure in patients with severe hematological diseases.