眼球摘除术患者的围手术期护理

总结了12例行眼球摘除术患者的护理,包括充分术前评估,术前准备及手术前、后心理护理、病情观察、药物治疗、出院后的健康指导等。认为精心的围手术期护理有利于患者的康复,提高患者生存质量。     

绝对期青光眼眼球摘除术38例围手术期的护理

目的探讨绝对期青光眼眼球摘除术围手术期护理的特点。方法回顾性分析总结2006-10-2009-04因绝对期青光眼而在我科行眼球摘除术38例患者的临床护理经验。结果所有患者没有出现术后感染、出血等并发症,均以良好的心态出院,能按时复查（术眼及健眼）。结论绝对期青光眼眼球摘术除术围手术期的精心护理,对促进患者身心康复,更好的适应社会,保护对侧眼视力有很重要的作用。     

1例胰岛素瘤合并A型血友病患者的围手术期护理

患者男,32岁,因反复意识不清8个月,进食或输注含糖液后,可以缓解。于2011年3月1日收入中国医学科学院北京协和医院内分泌科。人院后查血糖为2．6mmol／L,C-肽2．3ng／ml。胰腺灌注CT：胰腺钩突部小结节样明显强化灶,大小约0．5cm×0．8cm,考虑胰岛素瘤的可能性大。     

1例获得性血友病患者卵巢癌围手术期护理干预

通过对一例获得性血友病患者卵巢癌进行积极的术前准备、替代治疗护理配合、感染、出血等并发症的观察与护理、用药指导、皮肤护理、饮食护理、功能锻炼、心理支持健康教育及出院指导等一系列围手术期护理,已达到防止血友病所导致的术后并发症,使患者康复出院,并通过对患者家属等社会支持系统的教育指导,从而改善患者生活质量,减少并发症和经济负担。     

心理护理对眼球摘除术围术期病人心理状态的影响

<正>眼球摘除术是一种破坏性手术,主要是对于眼球内恶性肿瘤、绝对期青光眼、眼球破裂伤、眼内炎等眼部疾病及其他治疗方法无明显效果、眼球内部功能已基本丧失的病人采取的一种治疗方法。虽然手术解除了眼部的剧痛,但对病人造成了生理残疾、面部畸形,由此带来的精神上的痛苦是巨大的[1],病人常出现抑郁、焦虑等不良心理反应[2],同时也会对手术产生不良的影响[3]。本研究对围术期病人进行心理辅导,采用针对性护     

甲乙型血友病患者合并鼻肿物围术期护理

目的探讨血友病患者行鼻内窥镜手术术前术后护理要点,减少出血,预防并发症的发生。方法总结3名血友病患者(分别为血友病甲型2名及血友病乙型1名),行鼻内窥镜手术围术期的护理体会。结果 3例患者均能如期完成手术,无并发症的发生,顺利出院。结论血友病是一组因遗传性凝血活酶生成障碍引起的出血性疾病,以自发性出血或轻度外伤后出血不止为临床特征,手术往往引起出血不止甚至导致死亡,故一般是手术的禁忌证。术前对于患者及病房做好充分的准备,准确完成凝血因子的预试验,纠正贫血及凝血因子缺乏是非常重要的。术后严密观察出血征象,准确的应用替代疗法,严密观察出血征象,预防DIC及血栓的发生,遵守各项操作规范是患者顺利康复的关键。     

1例重型血友病行腹腔假性瘤切除的围术期护理

血友病是一种因遗传性凝血活酶生成障碍引起的出血性疾病,以自发或轻度外伤后出血不止,血肿形成及关节出血为特征,其中又以甲型血友病最为常见[1]。部分血友病病人的髋关节或腹腔内反复出血导致血肿伴机化,表现为质硬肿物并逐渐     

一例眼球钝挫伤患者围手术期的心理护理

目的：围手术期的心理护理使患者积极配合手术。方法：运用护理心理学对患者进行围手术期的心理护理。结果：患者保持良好的心理状态面对疾病。结论：围手术期的心理护理使患者以良好的心态配合医师顺利完成手术并建立了良好的护患关系。     

关节镜治疗血友病A型膝关节病10例围术期护理

2006年1月~7月,我们对10例血友病A型膝关节病关节镜手术患者进行精心护理,取得满意效果。现将护理体会报告如下。1资料与方法1.1临床资料本组10例,均为男性,9~46岁,平均28.5岁。合并膝关节僵硬4例,关节活动度:屈60°~90°,平均78°,伸0~30°,平均10°。膝关节滑膜炎5例,其他1例     

视网膜母细胞瘤眼球摘除术患儿围术期心理护理

目的:总结视网膜母细胞瘤患儿行眼球摘除术的围术期心理护理方法。方法:选择2009年2月～2012年2月在我科行眼球摘除术的14例视网膜母细胞瘤患儿为研究对象,对患儿及其家长实施全程心理护理。结果:本组14例患儿均顺利完成手术,病情稳定,术后均无并发症发生。结论:做好患儿围手术期心理护理,能有效减轻患儿及其家长的心理负担,提高患儿的生存质量。     

血友病患者发生骨筋膜室综合征的护理

总结了1例甲型血友病患者发生骨筋膜室综合征行深筋膜切开减压术后的观察和护理体会。护理重点包括注意观察患者术后切口出血、患肢血供,术后早期间歇应用气囊止血带、局部冰敷,协助患者正确进行功能锻炼。     

A perioperative uncontrollable bleeding in an elderly patient with acquired hemophilia A: a case report

Acquired hemophilia A should be taken into account in the differential diagnosis of perioperative bleeding in patients without any apparent reason for activated partial thromboplastin time prolongation.     

Application of DNA-based diagnosis to patient care: the example of hemophilia A

DNA-based carrier testing and prenatal diagnosis are rapidly expanding medical applications of recombinant-DNA technology. The ultimate goal of DNA-based diagnosis is the determination of the causative mutation, but, in general, this is possible only for large deletions, insertions, or certain nonsense mutation that, in most diseases, involve only a few percent of affected families. If direct diagnosis of the carrier state or fetal disease state is not feasible, indirect diagnosis can be performed by following the segregation of linked polymorphisms through the family pedigree. For such indirect diagnosis, DNA from multiple family members must be analyzed. Although this procedure is highly accurate in many families, errors can potentially occur because of meiotic recombination, genetic heterogeneity, new mutations, and nonpaternity. In this review, a general introduction to DNA-based diagnosis of mendelian diseases is presented and the methods and strategy are outlined. The use of these techniques for the diagnosis of hemophilia A is then described to illustrate the principles of diagnosis and to highlight some of the complexities encountered. DNA-based diagnosis is in its infancy and has the potential to revolutionize preventive medicine.     

Neurosurgery in a patient with severe hemophilia B: an experience using eftrenonacog alfa as perioperative management

Extended half‐life FIX (EHL‐FIX) concentrates have been developed with the purpose of reducing the frequency of infusions in patients with severe or moderate hemophilia B. We describe the case of a 63‐year‐old patient with severe hemophilia B (sHB) treated with FIX‐Fc fusion protein (rFIXFc) who underwent neurosurgery.     

1例血友病并发晚期急性重型乙型肝炎病人的护理

甲型血友病是一种X染色体连锁的隐性遗传性出血性疾病,为凝血因子Ⅷ基因异常所致,其临床特点为自发性关节出血和/或深部组织/肌肉出血。需反复多次输注人血第Ⅷ因子治疗,因此感染HBV的风险大大增加。重型肝炎是病毒性肝炎中一种最为严重的临床类型,病死率可高达50%～80%。治疗以休息、营养为主,防治并发症及人工肝支持系统和肝移植。在我国血友病合并重型肝炎病人的报道较少,治疗极为棘手,护理难度更大。我院于2010年12月28日收治了1例甲型血友     

Hepatitis C treatment with triple therapy in a patient with hemophilia A

We report a case of successful treatment of chronic hepatitis C infection with telaprevir-based triple therapy in a patient with hemophilia A complicated by factor VIII inhibitor. A twenty-two years old male with hereditary hemophilia A and high-titer factor VIII inhibitor was taking maintenance doses of recombinant factor VIII. He visited our clinic for treatment of his chronic hepatitis C with the newly instituted protease inhibitor based therapy. He was diagnosed with hepatitis C genotype 1a at one year of age. He was initiated on telaprevir, ribavirin and peg-interferon for treatment of hepatitis C and qualified for response-guided therapy. He completed treatment at 24 wk with minimal adverse effects. Notably, after 4 wk of hepatitis C treatment, his factor VIII inhibitor screen was negative and the dose for recombinant factor VIII decreased by half of the initial dosing before he was treated for hepatitis C. We suspect that suppressing hepatitis C may help decrease factor VIII inhibitor level and the need for recombinant factor VIII.     

血友病A伴抑制物一例及其免疫耐受诱导治疗探讨

目的 探讨血友病A伴抑制物的免疫耐受诱导(immune tolerance induction,ITI)治疗,提高血友病A伴抑制物患者的诊疗水平.方法 对重型血友病A患者用APTT标准曲线一期法测定凝血因子Ⅷ(FⅧ)活性(FⅧ∶C);用Bethesda法定量测定FⅧ抗体;用长距离PCR方法检测内含子22倒位.结果 经检测发现患者为FⅧ基因22内含子倒位;ITI治疗3个月后,患者FⅧ抑制物滴度下降为0,输注FⅧ后回收率＞66%,治疗6个月后达到抑制物清除标准,停止治疗.结论 该患者是国内首例采用ITI成功治疗血友病A伴抑制物的病例,ITI是目前最有希望根除血友病抑制物的方法.