一例WAS综合征患者硬膜下腔血肿清除术后行单倍体异基因骨髓移植的护理

目的 探讨一例WAS综合征合并颅内出血患者单倍体异基因骨髓移植治疗的护理经验。 方法 一例WAS综合征患者采用单倍体异基因骨髓移植治疗，针对血小板输注无效及自发性硬膜下血肿给予预防癫痫药物、输注血小板预防脑出血，移植过程中加强感染防控，联合个体化手术切口及湿疹护理、心理支持等一系列措施,成功完成该例异基因移植的综合性护理治疗。结果 该患+14d粒系、巨核系重建，外周血象恢复正常，顺利出仓，移植后随访至今6个月，患者生存良好。 结论 合并脑出血术后的患者，采取积极有效的感染防控、心理及并发症护理，为单倍体异基因骨髓移植成功提供了保障，该例WAS综合症的治疗经验对其他的合并脏器出血的先天遗传性疾病患者的移植护理提供了有经验参考，具有很大的实用价值。

Nursing care for one patient with Wiskott-Aldrich Syndrome treated with haploidentical bone marrow transplantation following removal of spontaneous subdural hematoma

Objective To summarize the experience of nursing care for one patient with Wiskott-Aldrich Syndrome (WAS) treated with haploidentical bone marrow transplantation (haplo-BMT) following removal of spontaneous subdural hematoma. Methods Haplo-BMT was utilized for one WAS patient with platelet-transfusion dependence and spontaneous subdural hematoma, a series of nursing measures was given to the WAS patient as follows, platelet infusion for preventing spontaneous secondary brain bleeding, nursing WAS skin eczema, nursing operative incision in head skin, prevention and treatment of infection, usage of prophylaxis forepilepsies , and psychological supports. The haplo-BMT was successfully completed in virtue of the comprehensive nursing cares. Results The WAS patient had one reconstruction of granulocyte lineage and megakaryocyte lineage at +14 days after hematopoietic stem cell infusion, and presented with a normal peripheral blood counts. The WAS patient has survived over 6 months till nowadays after haplo-BMT. Conclusion Depending on the comprehensive nursing care, haplo-BMT for the WAS patient was successfully performed. Therefore, the nursing care experience will be beneficial to the patients with hereditary disorders, especially complicated with spontaneous subdural hematoma during haplo-BMT.