Evidence-based practice of a steroid-resistant patient with severe graft-versus-host disease
10.3760/cma.j.cn211501-20190717-02007
- VernacularTitle:一例类固醇耐药患者并发皮肤严重移植物抗宿主病的循证实践
- Author:
Aiyun JIN
1
;
Xiaoyu ZHOU
;
Jianli ZHANG
;
Zhudan WANG
Author Information
1. 浙江大学医学院附属第一医院骨髓移植中心，杭州 310006
- From:
Chinese Journal of Practical Nursing
2020;36(13):1027-1031
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the evidence-based practice of a steroid-resistant patient with severe acute skin graft-versus-host disease caused by donor lymphocyte reinfusion.Methods:Clear the clinical problems of patients, through the development of a rigorous search strategy, according to the "6S" Pyramid model from the top to the bottom of the relevant literature in turn, after the evaluation of evidence level to determine the best clinical evidence.Combined with team experience and patient's actual situation, the acute graft-versus-host disease of steroid-resistant patients was treated while infection was strictly prevented. The non-invasive method of wet healing by topical high concentration tacrolimus smearing and sterile dressing sealing was compared with the invasive optical separation replacement therapy in vitro, which avoided puncture and sterile dressing. A series of possible complications of phototherapy.Results:The patient was relieved of swelling and pain 5 days after treatment, and was discharged on the 15th day of this hospitalization.Conclusions:Local high concentration tacrolimus smear plus aseptic dressing to seal wet healing is a noninvasive method that can relieve and treat severe acute graft-versus-host disease symptoms of steroid resistant patients. It is useful for similar clinical cases.
