摘要: |
2020年9月19日暨南大学附属广州红十字会医院收治1例因类风湿关节炎致全血细胞减少并发慢性创面56岁女性患者。经免疫抑制治疗、补充血液成分、应用造血生长因子、改善微循环、调整肠内营养等综合治疗改善全身情况,局部清创换药、冲洗联合持续负压封闭引流使创面生成新鲜肉芽组织后行皮片移植,术后抗感染、预防出血、营养支持等治疗,最终皮片存活,创面封闭,患者生活质量得到明显改善。该病例提示高活动度类风湿关节炎致全血细胞减少患者并发慢性创面时,积极有效的围手术期管理及手术治疗可以修复创面、改善预后。 |
关键词: 全血细胞减少 类风湿关节炎 慢性溃疡 创面修复 |
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A case report of chronic wound repair in a patient with Pancytopenia caused by rheumatoid arthritisa |
wangzhe
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暨南大学附属广州市红十字会医院
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Abstract: |
On September 19, 2020, a 56 year old female patient with pancytopenia and chronic wound caused by rheumatoid arthritis was treated in Guangzhou Red Cross Hospital Affiliated to Jinan University. After immunosuppressive treatment, rehydration and metachysis, application of cell stimulating drugs, improvement of microcirculation, adjustment of enteral nutrition and other comprehensive treatments to improve the general condition, local treatment is debridement and dressing change, flushing and using vacuum sealing drainage to make the wound generate fresh granulation, skin graft was performed, and postoperative anti infection, prevention of bleeding and nutritional support were treated. Finally, the skin graft survived and the wound was closed, the quality of life of patients was significantly improved. This case suggests that active and effective perioperative management and surgical treatment can repair the chronic wound and improve the prognosis in patients with pancytopenia caused by high activity rheumatoid arthritis. |
Key words: Pancytopenia Rheumatoid arthritis Chronic ulcer Wound repair |