目的:探讨急性髓系白血病相关急性发热性嗜中性皮病的临床特征及诊治。方法:报道1急性髓系白血病相关Sweet综合征分析其临床特点及诊疗经过,复习国内外相关文献。结果:62岁女性患者,因高热1月,皮肤红斑伴破溃半月住院,根据症状、辅助检验、皮肤学活检考虑为急性发热性嗜中性皮病,给予激素治疗后皮疹好转,出现血小板低,行骨髓穿刺见2%的原始细胞,患者拒绝再次骨髓穿刺,血液病诊断无法明确。出院后规律随诊,监测血小板计数均正常,给予激素控制皮疹。7月后,因发热及新发皮疹、四肢无力4天再次入院。因血小板低第二次骨髓穿刺:骨髓中见40.1%的异常髓系原始细胞群,表达MPO,考虑急性髓系白血病,化疗过程中患者很快出现急性重症肺炎(卡氏肺孢子虫感染),后继发多脏器衰竭死亡。结论:急性髓系白血病相关Sweet综合征患者长期使用激素免疫力低,对肿瘤原发病治疗的耐受性差,预后不佳。应尽早多次骨髓穿刺明确诊断,早期启动原发病的治疗。Objective: To investigate the clinical features and treatment of acute myeloid leukemia-associated acute febrile neutrophilic dermatosis. Methods: One case of acute myeloid leukemia-associated Sweet’s syndrome was reported, and its clinical features and diagnosis and treatment were analyzed, and the relevant domestic and foreign literature was reviewed. Results: A 62-year-old female patient was hospitalized with high fever for one month and erythema with broken skin for half a month. Based on the symptoms, auxiliary tests and dermatological biopsy, she was considered to have acute febrile neutrophilic dermatosis, and her rash improved after glucocorticoid treatment, low platelets were present, 2% of the original cells were found in bone marrow puncture, and the patient refused to repeat bone marrow puncture, so a definitive diagnosis could not be made. The patient was discharged from the hospital with regular fol
目的:评估两种不同冲封管频次(每24 h 1次与每12 h 1次)对1~3岁患儿外周静脉导管堵管率及留置时间的影响。方法:采用随机数字表法将2021年4月—6月3所医院1~3岁住院患儿分为观察组(n=115)和对照组(n=117),分别按照每24 h 1次与每12 h 1次进行脉冲式冲管、正压封管,比较两组患儿留置针堵管发生率和留置时间。结果:意向性分析显示观察组和对照组留置针堵管率分别为10.4%、8.5%,两组比较,差异无统计学意义(P>0.05),差值为-1.9%(95%CI:-9.4%~5.6%),观察组冲封管频次非劣效于对照组。观察组和对照组留置针留置时间分别为(63.74±19.72)h、(68.43±19.52)h,两组比较,差异无统计学意义(P>0.05)。结论:每24 h生理盐水冲封管1次可维持1~3岁患儿外周静脉导管通畅,在不影响其留置时间的前提下节约成本、减轻护士工作量,为幼儿外周静脉导管的维护提供依据。
