Hemodialysis patients with heparin induced thrombocytopenia nursing case.docVIP

 PAGE \* MERGEFORMAT 6 Hemodialysis patients with heparin induced thrombocytopenia nursing case [Keywords:] hemodialysis, heparin, thrombocytopenia, nursing Hemodialysis patients with heparin, is a clinical most economical and most practical method of treatment. But heparin induced thrombocytopenia, coagulation disorders caused by, there is high risk of bleeding. Our hospital in June 2006 to 2009 June were treated 561 cases of hemodialysis patients were heparin anticoagulant, which caused 1 case of thrombocytopenia, the clinical application of methylprednisolone pulse therapy in a significant effect, now nursing are summarized below. A case report Patients, female, May 21, 2009 due to nausea, vomiting 4 years, high serum creatinine, 1 week hospitalization with bleeding gums. Patients in 2006 and in our clinic hemodialysis treatment, are used heparin, nearly 1 week of bleeding gums, bleeding limbs, sometimes the skin. admission examination: T 36.7 , P 90 times / min, R 18 times / min, BP 16.1/7.7 kPa, face chronic diseases, anemia appearance, about 4 cm left hip shows 5 cm skin ecchymosis, skin of lower limbs scattered bleeding points on the skin, slight edema of both lower extremities. testing blood: PLT 35 109 / L, Hb 77 g / L, WBC 2.70 109 / L, RBC 2.25 1012 / L, blood Scr 860 mol / L, BUN 18.8 mmol / L. Bone marrow biopsy diagnosis: reduced proliferation of bone marrow hematopoietic tissue. methylprednisolone given after admission and following treatment with oral prednisone, and heparin-free hemodialysis to correct anemia, prevention of infection, treatment, regular monitoring of platelets. gingival bleeding in patients after treatment stopped, platelets returned to normal. Total hospital 34 d, discharge, bleeding skin, limbs, skin ecchymosis disappeared and left hip, review PLT 96 109 / L. 2 Care 2.1 General care observe whether the bleeding, the main observation of patient’s skin, oral mucosa and whether the new bleeding gums, n