[Afraid of deformity] What should I do if the knee joint with hemophilia bleeds repeatedly?

Hemophilia is a group of bleeding disorders caused by a lack of hereditary clotting factors, often accompanied by bleeding problems. For patients with hemophilia, the vast majority of bleeding occurs internally, and the common bleeding sites are in bones and joints. [Afraid of deformity] What should I do if the knee joint with hemophilia bleeds repeatedly? The most commonly involved joint is the knee joint, with a little spontaneous blood, which is slightly larger than the ankle joint, and often has symptoms of bruising. It can also be caused by an external impact, a fall and a sprain. This kind of bleeding has a greater impact on the patient, almost unable to walk and need to rest in bed. In this case, it is generally necessary to infuse coagulation factors in time, treat the symptoms, and control bleeding. Deal with every bleeding, take hemostasis measures and avoid complications. It can avoid joint deformation and even disability! It should be emphasized that patients with hemophilia must be tested regularly for blood coagulation, especially APTT indicators. If there are abnormalities, preventive infusion (preventive treatment) must be done in advance instead of waiting for treatment after bleeding. The advantage is that it can be extremely beneficial. It can prevent the joint and muscle damage of hemophilia patients and avoid disability due to disease. Learn more about “disease knowledge” or “hemophilia group communication” and other WeChat search public number: xueyb120

To protect children with hemophilia from bumps, parents must take care of these points!

Hemophilia is a hereditary and lifelong disease. When moms and dads who suffer from this disease mention this disease, they are even more downhearted and unable to boost their energy. In fact, this is not the case. As long as we do a good job in prevention and home care, The prognosis and quality of daily life of children are the same as normal people.   The so-called prevention work is to regularly infuse children with blood coagulation factors, rather than waiting for the children to have a condition before infusion. There are reports in foreign literature that regular and effective preventive treatment reduces joint damage in children by reducing the number of bleeding. It is the most convenient, time-saving and effective method to store and infuse freeze-dried coagulation factor powder injection. The storage temperature of freeze-dried coagulation factors is between 2-8°C. The cold storage room of general household refrigerators can fully meet the storage requirements, and the basic validity period of drugs can reach two years. Mom and Dad can learn to inject injections at home. Older children can also learn to inject themselves.   In addition, mom and dad must be caring people. Back home, take a closer look and see if there are any hidden dangers in the home that could easily hurt children. For example, are there any sharp corners or protrusions in the children’s toys, whether the corners of the table are covered with anti-collision sponges, is the floor too slippery or is there any uplift, see if you can put a blanket? A soft toothbrush? Are children’s nails too long? Check every corner of the house to minimize the risk of injury, especially for younger children.   In life, how to protect children with hemophilia from bumps and minimize the number of bleeding, parents can start from the following aspects:    1. Usually take him to pay attention to relatively safe places, and anticipate the danger in advance. Protect your body and try to avoid injury.   2. Children have fun, sometimes they forget the things around them and bump them. Sometimes it is useful for adults to call out a reminder in advance. Shout “Be careful of the corner of the table”, “Beware of the pit in front of you”, “I’m going to set off firecrackers over there, bang”…  3, usually practice drawing, piano, handicraft, or slide, skateboard, massage ball Wait to improve hyperactive behavior.  4. Tell some plausible stories patiently, encourage and guide children who learn to be obedient, praise and strengthen good behaviors, and establish good living habits.   5. Discover his points of interest, accompany him to have fun, guide scientific hobbies, and cultivate a sense of accomplishment and success. “Skin” children may be smart and need patience.  6. ​​Observe the developmental status. For children with developmental disabilities or ADHD, you need to see a relevant professional doctor for consultation.   You need to know that the “pi” child is not necessarily a bad child, so don’t hurt the child psychologically. Don’t have character problems, and help him grow up mentally and behaviorally.

There are more and more contraindications for infusion compatibility, how should medical staff respond?

Cases Due to the increasing number of outpatient infusion patients, the trouble that bothers medical staff has also come-when the infusion bottle is changed or the intravenous injection is used, the infusion tube always appears discoloration, turbidity or precipitation, which is to a certain extent to the operator And the patient brought trouble. It is better to deal with these situations when changing fluid and refilling fluid, just change an infusion tube directly. Some doctors and nurses like to use “potting” instead of intravenous injection of medicine, inhaling the liquid in the ampoule directly from the upper end of the infusion set, instead of using a syringe to suck the liquid or inject it from under the infusion tube. Although it is simple and easy Yes, but if the medicinal solution confluent in the infusion tube is contraindicated, discoloration, turbidity, and precipitation occur, it is not good! The process of drug “reaction” is not only seen by medical staff, but also by patients. At this time, it is not so easy to change the tube. This enters the infusion tube to produce contraindicated drugs. If you change the tube, the drug solution will be scrapped. The medicine is useless, and the patient is unwilling. Who will pay for the medicine? In this case, it is easy to cause medical disputes. What should I do? Comment on the contraindication of intravenous medication, which is a realistic proposition that medical staff cannot avoid. Intravenous medications and contraindications between medications will not only cause troubles to the work of medical staff, but also cause panic to patients and family members, as well as the consequent waste of liquid medicines and the additional cost of supplements. All medical staff need to face. What is the compatibility taboo? Compatibility contraindications refer to the compatibility of drugs in vitro, which directly cause physical or chemical interactions, which will affect the efficacy of drugs or cause toxic reactions. Not all drug compatibility is reasonable. Some drug compatibility weakens the therapeutic effect of the drug and leads to treatment failure; some drug compatibility increases side effects or toxicity, causing serious adverse reactions; and some drug compatibility increases the therapeutic effect excessively. If the body can tolerate it, it can also cause adverse reactions and even endanger patients. Medical staff should actively respond and effectively avoid it. 1. What are the commonly contraindicated drugs in clinical practice? 1. The main component of ambroxol is ambroxol hydrochloride, and the auxiliary material is mannitol. It is not suitable to mix with alkaline solution. In a solution with a pH greater than 6.3, it may cause ambroxol free base precipitation. For example, in the case of aminophylline injection + ambroxol injection, the infusion solution will precipitate and become turbid. 2. Calcium (including calcium gluconate injection, compound sodium chloride injection, sodium lactate Ringer injection, etc.) is not compatible with oxidants, citrate, soluble carbonate, phosphate and sulfate. With the western medicine Amoxicillin Clavulanate Potassium, Ceftriaxone Sodium, Cefpiramide, Cefotiazole, Cefepime, Fusidic Acid, Polyene Phosphatidylcholine, Omeprazole, Pantoprazole, The compatibility of motidine, glycyrrhizin diamine, dexamethasone, and leucomycin can cause precipitation, and the compatibility with traditional Chinese medicine injections Qingkailing, Tanreqing, Yanhuning, and Danshen can cause precipitation. It is not recommended to use together. For example, in clinical ceftriaxone sodium + calcium gluconate injection, the infusion will gradually become turbid. Ceftriaxone sodium is an anion and easily forms insoluble precipitates with cationic calcium. The infusion solution gradually becomes turbid, forming precipitates or particles. 3. Proton pump inhibitors Proton pump inhibitors are all strongly alkaline, with contraindications, too many to prevent. For example, omeprazole + vitamin C, the compatibility result: the infusion solution gradually changes color or aggregates and precipitates. The chemical structure of omeprazole is composed of a benzimidazole ring, a pyridine ring and a sulfinyl group connecting these two ring systems. It is weakly basic and very unstable under acidic conditions. 4. Traditional Chinese medicine injections Chinese medicine injections have many safety problems. Medical staff have a deep understanding of this point in clinical application. On the one hand, due to the complex composition of traditional Chinese medicine injections, the quality control of medicinal materials, extracts, preparations and product batches cannot be as fine as chemicals, and the adverse reactions caused are also difficult to determine. On the other hand, it is mainly caused by the irregular clinical use of Chinese medicine injection. 5. In the clinical application of compound preparations, attention should be paid to reactions that occur during contact with other drugs. Rudanhong powder injection is a compound preparation in itself, with complicated injection components and complicated preparation process. A single drug and a single bottle should be used when medication, and avoid contact with other drugs when paying attention to refilling. 2. How to prevent compatibility contraindications during intravenous medication? Compatibility taboos will appear in every link of drug contact, not only in infusion bottles and syringes, but also

What treatment methods are more effective for children with thrombocytopenia?

The incidence of thrombocytopenia in children is also very high, and this blood disease is very harmful to children. Therefore, patients and parents need to actively cooperate with treatment to relieve the disease as soon as possible and reduce the bleeding tendency caused by low platelet count. ——So, how to treat child thrombocytopenia? In the treatment of thrombocytopenic purpura in children, the commonly used treatment methods are mainly the following: 1. The commonly used treatment method is the application of adrenal cortex hormones, but it can only assist in hemostasis in the acute phase and does not have much effect on the increase of platelets. 2. Combined treatment of traditional Chinese and western medicine: combined treatment of bone marrow cavity infusion of Chinese medicine, starting from adjusting the immune function of the patient, improving the bone marrow hematopoietic microenvironment, alleviating clinical symptoms, and increasing the number of platelets. 3. Acute patients need blood transfusion, requiring replacement of the loss of red blood cells and hemoglobin, and simultaneous transfusion of platelets and fresh blood, that is, platelet transfusion, which is easier to achieve the purpose of hemostasis than whole blood transfusion. But for patients with thrombocytopenia, frequent blood transfusions may lead to the production of antibodies in the body, which is even more detrimental to the recovery of the disease. 4. Resection of the spleen can reduce the destruction of platelets, thereby ensuring that there are enough platelets in the blood. As the platelets rise and become normal, bleeding and other clinical symptoms will disappear, but the cost is generally higher, and the spleen is the largest in the body Immune organs are prone to infection or other diseases after removal. In addition, in the process of treating thrombocytopenic purpura in children, treatment can be carried out according to the clinical manifestations of children. Although it is different from adults, it is not much different. The cause can be treated according to the cause of thrombocytopenia. For more patient communication help, please follow the WeChat public account [Thrombocytopenia Patients Association] xxbjs75

After Liqiu, shouldn’t it be time to go for infusion and vascularization again? Rumor: The risk is great! No benefit

Many elderly friends like to infuse fluids twice a year to open blood vessels. They think this can improve blood viscosity, dredge blood vessels, and reduce cardiovascular risks. But is this really the case? As we age, various organs of our body will inevitably experience a certain degree of aging, and our blood vessels are no exception. The blood vessels that were originally elastic and very common have gradually become aging and narrow, but if you take this This kind of aging and narrowing problem can be imagined as the same as the clogged sewer. Through more flushing, the smooth flow can be restored and the narrowing can be improved, which is a big mistake. In order to clarify the problem of how blood vessels are hardened and narrowed, we must first briefly introduce how our blood vessels harden and narrow. There are many factors that affect vascular health, some of which are beyond our control, such as the growth of age, such as family inherited personal physical factors, and some are the effects of chronic diseases, high blood pressure, hyperlipidemia, diabetes, if not active Control and improvement will affect the health of blood vessels. High blood pressure will cause long-term pressure on arteries and blood vessels, which will gradually degenerate and harden the blood vessels. Excessive blood pressure will also respond to the health of the vascular endothelium, leading to damage to the vascular endothelium; Inflammation of vascular endothelial cells can also lead to increased blood viscosity. Blood lipids are deposited under the endothelium of the vascular wall and gradually form atherosclerosis. High blood sugar can also affect the health of vascular endothelial cells and affect large and small blood vessels. Very large, it is an important factor leading to vascular sclerosis. In addition to the three-high problem, some bad habits in life will also affect our blood vessel health, such as smoking, long-term heavy drinking, high-salt, high-fat and high-sugar diet, sedentary exercise, obesity, staying up late and other bad habits and Life factors will affect our health, leading to the gradual aging and narrowing of blood vessels. Our body responds to the lipid deposited under the endothelium of the blood vessel wall. First, it is transported by high-density lipoprotein. If the deposit is too large to be completely transported, our body will further discharge it. Macrophages swallow the deposited lipids. The lipids will not disappear after being swallowed. Instead, they will be oxidized into foam and gradually fuse. A lipid core is formed under the endothelium of the blood vessel wall. Damaged blood vessel wall endothelial cells will proliferate and degenerate, forming fibrous caps formed by smooth muscle cells, fibrin, etc. Such atherosclerotic plaques wrapped in lipid cores will cause blood vessels to gradually harden and narrow. Regular infusions can’t clear blood vessels and remove garbage. From the above introduction, everyone should understand that the problem of hardening and stenosis of blood vessels is a physiological change of blood vessels itself caused by various factors, even if it is accumulated fat. The quality is also under the endothelium of the vascular wall and is enclosed in the vascular endothelium. If you want to clear the blood vessels by infusion, it is impossible to “wash away” the vascular garbage. Many friends have regular infusions, not when they are in need of physical health or medical treatment, but only by infusion of saline or glucose solution, thinking that this approach can wash away blood vessel waste and protect blood vessel health, but The actual situation is: our blood itself is constantly flowing, and the external infusion is only the infusion of exogenous normal saline and glucose water into the body. This infusion not only temporarily increases blood volume, but also Can you understand such a simple truth that it cannot nourish blood vessels, nor can it accelerate blood circulation, and wash away the “trash” of blood vessels? Infusion to dredge blood vessels will also bring certain risks. Many friends take infusions improperly. In fact, for infusion medication, although there have been many abuses in the past, the management has become more and more strict. Compared with oral drugs, infusion is an invasive way of administration. Drugs or liquids are directly injected into the blood, and there are more risks of medication. Generally speaking, only cases that require emergency treatment, oral administration cannot be given. Drugs (such as severe vomiting, etc.) or emergency treatment before surgery are required to be administered by infusion. For general disease problems, do not administer by infusion if they can be taken orally. What are the possible risks of infusion and vascular access? It is mainly the pollution and infection risk that may be caused during the infusion process. The infusion equipment and the infusion environment may cause the risk of infection in the patient during the infusion injection process; and the infusion

Albumin is not a nutritional medicine. Injecting albumin in advanced lung cancer is a waste of money unless the person is swollen

The liver is the main organ for protein synthesis and metabolism in our body. Almost all proteins are synthesized and metabolized in liver cells. In patients with advanced lung cancer, due to the massive consumption of tumor cells and insufficient intake of nutrients, two reasons will cause low plasma albumin. In some patients with lung cancer and liver metastases, the ability of the liver to synthesize protein is reduced, which will aggravate the decrease in albumin. Some netizens asked the question: The albumin in advanced lung cancer is low, is it better to inject albumin directly? Many people regard albumin as a nutritional medicine, as a medicine to improve immunity, which is a misunderstanding in understanding. In fact, for malnourished terminal cancer patients, the nutritional value of albumin is not high. Any exogenous albumin cannot be directly absorbed by human tissues. The artificially infused albumin must be metabolized by the liver to enter the patient’s body, decomposed into various amino acid components and short peptides, and then synthesized into its own albumin by the liver. From this process, albumin only provides a source of nitrogen for the body. For people with normal nitrogen metabolism, the infusion of human albumin is no different from taking ordinary high-protein foods. So what is the main function of albumin? In clinical practice, when there is obvious subcutaneous edema in tumor patients, or when pleural fluid, ascites, or pericardial effusion occurs, doctors usually advise patients to inject albumin, and many patients do not necessarily test albumin at this time. The purpose of albumin infusion is to increase colloidal osmotic pressure and reduce edema and pleural and ascites production. Many people don’t understand the concept of colloidal osmotic pressure. To put it bluntly, albumin can lock the water in blood vessels, maintain the integrity of the vascular endothelium, and prevent water from small molecules from leaking out of the blood vessel through the blood vessel wall. Albumin is a biological macromolecule, which does not easily penetrate the blood vessel wall. When its content is significantly reduced, the osmotic pressure of the colloid in the blood vessel will decrease, and the pressure difference between the inside and outside of the blood vessel will cause the water inside the blood vessel to leak out of the blood vessel, resulting in interstitial There is too much water retention in the fluid, resulting in subcutaneous edema, and even formation of serous cavity fluid (pleural and ascites). This is an important reason why cancer patients with malnutrition and low albumin are prone to edema and long chest and ascites. Patients with advanced lung cancer have low albumin. If the eating function is normal and the appetite is also normal, the first choice is diet supplement. The diet is based on high-quality protein, including fish, meat, eggs, and milk. Pay attention to nutritional balance. Food should be diversified, and vegetables and fruits should be given appropriate vitamins and dietary fiber. If the appetite is not good, the digestion and absorption function will decline, eat as little as possible, and change the color and flavor of the food to increase the patient’s appetite. Malnourished patients who eat less food can infuse glucose, balanced amino acids and fat emulsions to supplement the three major nutrients the body needs. Especially amino acid preparations, which belong to the raw material of synthetic albumin. Albumin is one of blood products and a scarce resource. Simple albumin is low, mainly dietary therapy or auxiliary infusion of amino acid preparations. Human albumin is not only expensive, but also has a low risk of infection. The infusion of albumin in the hospital has strict indications. It is limited to rescue, severe or pleural fluid caused by liver cirrhosis or cancer and albumin is less than 30g/L. patient.

Some heart diseases need more fluids and some heart diseases need less fluids? Why exactly? The doctor said clearly

As a cardiologist, during rounds, it also affects how much the patient ate, drank, and urinated 24 hours a day. He also checked the nurse’s record sheet to see how much fluid the patient had infused. But the degree of concern for each patient is different. Not every heart patient should have less fluids and less water. Some heart patients also need more fluids and a lot of fluids. Most heart diseases have little to do with fluids. As long as the therapeutic drugs are infused, There is no need for infusion therapy if you eat and drink normally. 1. Which heart diseases require a large amount of rapid infusion? Acute right ventricular myocardial infarction, or acute inferior wall with right ventricular myocardial infarction often has low blood pressure. At this time, it is difficult to raise blood pressure through blood pressure medicine alone, and even through blood pressure medicine alone If the blood pressure is raised, the treatment expectation cannot be achieved, and a large amount of rapid infusion is needed for rescue at this time. Acute right ventricular myocardial infarction, or acute inferior wall with right ventricular myocardial infarction, right ventricular diastolic dysfunction obstructs venous return, leading to further increase in venous pressure. Through a large amount of rapid infusion to increase right ventricular preload and cardiac output, improve hemodynamics, reasonable volume expansion treatment should be carried out under hemodynamic monitoring, the left ventricular output increases, blood pressure rises, and the effect is considered satisfactory. . 2. Conventional transfusions are sufficient for most heart diseases. There is no excessive requirement for infusion and drinking. For most heart diseases, as long as they can eat and drink normally, and under the premise of no surgery, no rescue, and relatively stable condition, just take medicine to control it. Yes, no special infusion is required. It is not a requirement to restrict infusion or to restrict drinking water. Heart disease is a large range, including many diseases, such as coronary heart disease, arrhythmia, cardiomyopathy, valvular disease, congenital heart disease and other diseases. These diseases are relatively stable or without surgery or rescue, and no special infusion is required. In heart disease, the most concerned about the amount of fluids infusion, drinking, and urine is heart failure or heart failure. 3. Heart failure requires less fluid infusion, but it is not necessary to drink less water. Heart failure is not the name of a heart disease, but a group of syndromes. If most heart diseases are not treated properly, they may cause the heart to enlarge, and then There will be heart failure. For example, the aforementioned coronary heart disease, myocardial infarction, cardiomyopathy, valvular disease, congenital heart disease, pulmonary heart disease, arrhythmia, etc., may cause the heart to expand. Once the heart is enlarged, heart failure may occur, which may lead to the heart decline. To put it simply, heart failure means that the function of the heart is no longer good. Whether it is the pumping function of pumping blood to the whole body after the heart is contracted, or the function of returning blood to the heart to prepare to transport blood again after the heart is relaxed, it will gradually decline. The most typical symptoms of heart failure are chest tightness, breathlessness, dyspnea, swelling of the lower limbs, and fullness of the abdomen. The five-year mortality rate of chronic heart failure is 50%, and the one-year mortality rate of severe heart failure is 50%. The main manifestations of heart failure are chest tightness, breathlessness, difficulty in breathing, inability to rest on your back, edema of lower limbs, etc., and one of the main reasons for these manifestations is the relative excess of body water. If you have a lot of fluids or drink a lot of water, then the total water intake is more than the water discharged, then more and more water is naturally left in the body; this water needs the heart to metabolize, so it will increase the burden on the heart. The heart itself is already failing. At this time, increasing the workload of the heart will undoubtedly make the situation worse and have severe breathing difficulties. More and more water will naturally cause aggravation of heart failure, and even induce acute heart failure, leading to death. This is the main reason why patients with heart failure restrict infusion or even drink water. Infusion must be restricted, as long as the therapeutic fluid can be infused into the body, under this premise, as little as possible infusion to reduce the burden on the heart. However, drinking water is not necessarily restricted. At least everyone’s basic water must be guaranteed. Otherwise, the human body lacks water and more problems will occur. As long as the heart failure is relatively stable, or the urine is normal, you can drink water normally; and even if you have oliguria, you can’t solve it by restricting drinking water, but you must find a way to adjust the drug to increase the urine. On the issue of drinking water, the first is to meet physiological needs, and the second is not to overdo it, and there is no need to strictly limit drinking water. In short, if there are heart enlargement, heart failure, heart failure and other problems in heart disease, then it is true that you should not drink too much fluid or deliberately drink plenty of water. The most important thing is to observe whether the weight increases or whether the urine output decreases, so as to find the stable state of heart function in time. If the weight gains or the urine output decreases, you must contact the doctor in time.

Hemophilia Society: What are the half-lives of factor 8 and factor 9?

A common treatment plan for hemophilia is the infusion of coagulation factors in sufficient quantities, which involves the infusion of eight factors and nine factors corresponding to the common types of diseases. The doctor will keep the original dosage or reduce the dosage as appropriate. Ps: Types of coagulation factors. Popular science: Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅵ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ, Ⅻ, Xlll, etc. The coagulation factors discovered after factor XIII have been verified for many years. Function, no decisive influence, no longer included in the number of clotting factors. Factor VI is actually the fifth factor activated, and the name of factor VI has been cancelled. ——What are the half-lives of factor 8 and factor 9? The half-life of eight factors is 8 to 12 hours/infusion every 12 hours; the half-life of nine factors is 16 to 24 hours/infusion once a day. Standardized clinical treatment emphasizes receiving treatment in a timely and sufficient amount according to the standard dosage, because severe bleeding is life-saving, so it can no longer be saved in such an extraordinary period. If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xueyb120

The elderly have vascular sclerosis. Can fruits and vegetables soften blood vessels? This article

A netizen asked: The old father was hospitalized for examination. The doctor said that the blood vessels were somewhat hardened. Need to lose a few days of water in the hospital, but as a young daughter but in the field, want to know what to eat to soften blood vessels is best? The question is very specific, and its filial piety is very commendable, but at the same time, these short descriptions reflect many misunderstandings. Today we will use this question to sort out some common misunderstandings about arteriosclerosis . Is the elderly suffering from arteriosclerosis? With the increase of age, various organs of the elderly’s body also begin to age, and the blood vessels that transmit blood for the body are no exception. The sign of vascular aging is that the elastic substances in the blood vessel tissue gradually decrease, and the blood vessels gradually appear. Symptoms such as loss of elasticity, hardening, and stenosis. If the body is also affected by high blood pressure, high blood fat, diabetes and other three problems, the atherosclerosis of blood vessels will be faster, blood vessel stenosis may occur, and even the heart, brain and other organs may be caused by vascular sclerosis stenosis The problem of insufficient blood supply. It should be realized that the hardening of blood vessels in the elderly is an inevitable aging phenomenon. As for the hospital check, the doctor said that the blood vessels are somewhat hardened. I don’t know whether this hospital is a regular hospital. What does the doctor say specifically? Yes, but just talking about arteriosclerosis, it is not necessarily a disease problem, and only when the arteries are hardened to a certain extent, or the plaque formed causes severe narrowing of blood vessels, may it affect the body’s blood supply, form coronary heart disease, and insufficient blood supply to the brain, etc. In terms of disease problems, for mild normal physiological senile arteriosclerosis, we often regard it as a normal aging physiological change that is more reliable. Can blood transfusion work in the elderly? We have talked about the problem of infusion of blood vessels and softening of blood vessels in the elderly. For normal health conditions that do not require medical intervention, the practice of infusion of blood vessels for a few days to improve vascular sclerosis is unscientific and non-scientific. Based on any clinical application. In addition to not being able to effectively improve vascular sclerosis, there is a risk of various medications and injection adverse reactions caused by infusion during infusion, which is completely unnecessary! If the vascular sclerosis is more severe in the elderly, such as lacunar cerebral infarction, or even motor dysfunction, language and sensory dysfunction, and paralysis of the limbs, the necessary medical treatment is of course It should be, in this case, the doctor may combine the actual situation of the patient to reduce intracranial pressure, improve cerebral dehydration, have thrombolysis, protect the cardiovascular, correct the related treatment of the three highs, etc. In this case, the infusion Treatment is of course necessary. Because there is no specific description of the degree of vascular sclerosis and possible diseases in the question, we cannot judge whether this elderly person needs infusion treatment, but if it is only mild vascular sclerosis, the body organs do not have related disease problems due to vascular sclerosis, When the body is basically healthy, infusion therapy is not needed. It is still recommended that when you go to the hospital, you must choose a regular medical unit. Some medical units, under the guise of healing, make a diagnosis of a virtual head and brains. Starting from the interests alone, they often get some “infusion.” The issue of “opening blood vessels” comes out. Such a hospital is really better than not going. Can the elderly be hardened again? The friend asked, what kind of fruits, nuts or vegetables can soften the blood vessels in the elderly? Unfortunately, this question is meaningless. The hardening of blood vessels is a gradual process, which is gradually formed under the influence of body aging, family genetic factors, and bad lifestyle habits and three high chronic diseases. This process occurs slowly, and it is also often irreversible. For blood vessels that have already hardened and lost their elasticity, what we should do is to slow down the process of further hardening of the blood vessels, as far as possible to reduce the cardiovascular and cerebrovascular diseases and other health risks caused by the hardening of the blood vessels, rather than always thinking about how Let the hardened blood vessels soften again. Of course, for elderly friends with atherosclerosis, healthy dietary conditioning is an important foundation for the prevention of cardiovascular and cerebrovascular diseases. As this friend asked, fruits and vegetables and nuts are good healthy diets. Fresh vegetables are rich in various vitamins and trace elements. They are also low-fat and low-sugar ingredients, and you can eat more;

Farewell: What preparations do patients with severe aplastic anemia receive before infusion of cord blood?

Xiebeilu studio WeChat add369456 severe aplastic anemia (severeaplastic anemia, SAA) is a type of bone marrow hematopoietic failure caused by physical, chemical, pharmaceutical, biological and other reasons, its performance is mainly reduced bone marrow hematopoietic function, whole blood cells Reduce and symptoms such as bleeding, infection, and anemia. The pathogenesis of SAA is inherent defects of hematopoietic stem cells, damage to the hematopoietic microenvironment, abnormalities of cellular and humoral immune mechanisms, and so on. Therefore, cord blood transplantation is widely used in SAA patients with poor immunosuppressive therapy. 1. Environmental preparation ATG, cyclophosphamide, and cyclosporine are all potent immunosuppressive agents. In patients with low immune function, the infection will definitely increase. Therefore, all transplant patients must stay in a 100-level laminar flow bed for complete environmental protection. The 100-level laminar flow bed has a filter efficiency of 99.99% and efficiently purifies the air. At the same time, a plasma sterilization machine is placed in the ward, which has high efficiency sterilization and high efficiency degradability, can generate positive ions and negative ions, and changes the structure of bacteria. To the role of sterilization. Sterilize the ultraviolet air in the room twice for 30 minutes each time; regularly monitor the number of colonies on the surface of the air and objects. Prepare rescue medicines and related items, such as ECG monitors, negative pressure suction devices, dexamethasone, epinephrine hydrochloride, etc. 2. The patient is going to shave and prepare the skin 1 day before check-in, take a bath and change sterile clothes, eat a sterile diet, and sterilize in a microwave oven for 3 to 5 minutes. 3. Medical staff prepare medical staff to strictly abide by the principle of aseptic operation, and ensure the accurate and timely application of pretreatment drugs, closely observe the changes in the disease, master the adverse reactions of drugs, and give patients timely treatment for infections and bleeding. 4. Nursing of infusion of cord blood slowly and slowly push dexamethasone 5mg, intramuscular injection of promethazine hydrochloride 25mg. The umbilical cord blood is taken out from the liquid nitrogen at -196 ℃ and placed in a constant temperature water bath at 37 ℃ to melt. The transfusion device during infusion should contain a filter. The saline is flushed before and after the infusion. At the same time, another intravenous route was infused to inject Methylprednisolone 40mg anti-allergic, and electrocardiographic monitoring was performed to monitor blood pressure, breathing and pulse every hour, and pay attention to whether the patient was suffering from chills, high fever, and palpitation. After the infusion, the patient’s consciousness and blood pressure should be closely observed. If a headache occurs and the blood pressure rises significantly, it should be dealt with in time according to the doctor’s instructions. If hematuria occurs within 2 hours after the infusion, it is normal, usually within 24 hours. disappear. Due to the addition of dimethyl sulfoxide during umbilical cord blood preservation, and dimethyl sulfoxide is excreted through the lungs, the patient will exhale a special garlic odor. In order to expedite the discharge of dimethyl sulfoxide from the body and reduce its side effects on the body , Instruct the patient to exhale vigorously during the infusion.

Study shows bevacizumab may be effective for hereditary telangiectasia

Bevacizumab was studied because it is an antibody against vascular endothelial growth factor (VEGF), which is elevated in HHT patients due to potential genetic defects. This multi-center international InHIBIT bleeding trial included 238 patients with HHT and moderate to severe bleeding (mean age 63 years, range 29-91). They were recruited in 12 international centers. The median treatment period for bevacizumab infusion was 12 months (range 1-96 months), and the median infusion for bevacizumab was 11 times (range was 1-74 months). These patients had epistaxis (42%), gastrointestinal bleeding (19%), or both (39%). Compared with before treatment, the patient’s average hemoglobin increased by 3.2g/dL in the first year of treatment (mean hemoglobin 8.6g/dL and 11.8g/dL, P&lt..0001). During this period, during their first year of treatment, their mean reduction in nosebleed severity score (ESS) was 3.4 points (mean ESS6.8 vs. 3.4; P&lt..0001), or about 50%. In addition, compared with the first 6 months of treatment, in the first 6 months of bevacizumab, the patient’s red blood cell transfusion was reduced by 82% (median 9.0 units vs. 0 units, P&lt..0001), iron transfusion Infusion reduced by 70% (median of 8.0 infusions compared to 2.0 infusions, P&lt..0001). According to the severity of the disease, there is no significant difference in the efficacy of bevacizumab, regardless of the potential pathogenic gene mutations such as ENGvsACVRL1, the results are similar. Protocol: Induction period: bevacizumab 5mg/kg is infused every 2 weeks for a total of 4 to 6 times. Maintenance treatment: lose once every 4-12 weeks. Bevacizumab is well tolerated and adverse events (AE) occur in 38% of patients, including hypertension (18%), fatigue (10%), proteinuria (9%), and myalgia/arthralgia ( 6%). Only 5% of patients stopped treatment due to AE, and there was no fatal AE.

Everyone has a brain! The doctor just made a film, infusion! Why not rescue? The truth is so

I went to the emergency consultation yesterday and happened to meet and rescue a stroke patient! The family members do not know who is shouting there: What doctor are you all? My mouth is crooked, and my legs can’t move anymore. We are not doctors who know the cerebral infarction at a glance. You still have to do CT. Are you delayed and can you afford it? We understand the mood of family members, but is the cerebral infarction you see really a cerebral infarction? 1. The cerebral infarction you see is not a real cerebral infarction. To be precise, when we find hemiplegia, aphasia, hemiplegia, and so on, we must doubt the stroke. But there are two types of stroke, one is cerebral infarction and the other is cerebral hemorrhage. Before brain CT, no one can accurately judge whether it is cerebral infarction or cerebral hemorrhage. I haven’t learned anything from doctors. I know that cerebral infarction is blocked by blood vessels, and it is necessary to open blood vessels with blood circulation; cerebral hemorrhage is to burst blood vessels and stop bleeding. The treatment method is completely contradictory. If it is really cerebral hemorrhage and thrombolysis according to cerebral infarction, it will definitely be worse, and it will be different. It can even be said to bear legal responsibility and have to be jailed. Therefore, all patients with suspected stroke, that is, all stroke patients, must go to the hospital for brain CT to further determine whether it is cerebral infarction or cerebral hemorrhage, and then know how to treat it. Second, infusion is treatment, but if the diagnosis is cerebral infarction in two cases, then the next step is to immediately rescue treatment and open blood vessels. The method of opening blood vessels is nothing more than infusion thrombolysis or thrombectomy. However, we must regret to tell you that there are very few hospitals that can carry out thrombectomy technology, so many patients with cerebral infarction will not be sent to the operating room even after diagnosis. Then everyone must say, then thrombolysis! Yes, thrombolysis is to “dissolve” thrombus through infusion to restore blood flow in blood vessels; but it is such a “seemingly simple” infusion thrombolysis, most hospitals have not carried out for various reasons, one of the main The reason is that they believe that thrombolysis has a risk of bleeding, and dare not thrombolysis. Then, there are two possibilities for infusion into the hospital. One is non-thrombolytic conventional infusion. In other words, there is no treatment for opening blood vessels, but only symptomatic treatment. Then this kind of infusion is really not good for improving the survival rate of patients, reducing the disability rate of patients and so on. Only after thrombolysis or thrombectomy and opening of blood vessels at the first time can we effectively save the lives of more patients with cerebral infarction, reduce mortality and reduce the occurrence of sequelae. 3. It is very important to open blood vessels, and it is the only correct method. 1. Golden 3-6 hours are not to be missed. Thrombolysis is the most convenient and feasible. Cerebral infarction occurs more than 5 minutes, and irreversible damage to nerve cells will occur. If the blood flow in the ischemic penumbra can be quickly restored in a short period of time, some brain tissue functions can be reversed, and nerve cells can survive and restore function. It is currently considered that it is best to be delivered to the hospital within 3 hours, no more than 4.5 hours, and more than 6 hours at the latest. Therefore, a stroke must occur every second. If you can reach a thrombolytic hospital, you will be lucky. In fact, this method of opening blood vessels seems to the people to be an infusion, but the infusion drug is a thrombolytic drug, but it seems to be an infusion, but thrombolytic infusion will cause systemic hemorrhage or cerebral hemorrhage. 2. The technique of thrombectomy is very difficult. Many hospitals have not carried out emergency thrombectomy for patients with cerebral occlusion before anterior circulation occlusion within 6 hours. The American guidelines state that patients with acute cerebral infarction caused by anterior circulation arterial occlusion within 6 hours of onset can be treated with emergency mechanical thrombectomy. The European organization guidelines recommend that for patients with anterior circulation occlusion within 6 hours of onset, combined with emergency thrombectomy in the emergency department on the basis of intravenous thrombolysis within 4.5 hours. Simply put, it is to advance a tube from the blood vessel of the thigh to the large blood vessel of the brain, and use a special device to pull the thrombus out. This has higher requirements for hospital equipment and doctors, and the risks are also greater. Fourth, regular early blood vessel opening can reduce mortality and sequelae, but can not 100% avoid severe paralysis and aphasia left by cerebrovascular disease survivors account for 50% -70%, part of the reason is that China has too few thrombolytic hospitals There are even fewer hospitals taking thrombi. Many patients do not receive open blood vessel treatment, but only routine symptomatic treatment, such as causing a huge number of sequelae. But even this part of the people who can open blood vessels, because the area is too large, or the blood vessels are opened late, resulting in sequelae. So 100% avoid the sequelae of cerebral infarction, avoid aphasia, hemiplegia, hemiplegia, long-term bed rest, eating

Shi Shurong’s medical remarks: How does platelet reduce bleeding in different parts, how to stop bleeding correctly?

Platelets are extremely important for the body’s hemostatic function. When platelets decrease, the body’s coagulation function is abnormal, and patients will have different degrees of bleeding tendency. The lower the platelet value, the higher the risk of bleeding. Director Shi Shurong’s WeChat signal zkxk9999 In order to avoid further damage to patients with thrombocytopenia caused by bleeding, family members and patients must understand the correct method of hemostasis. Clinically, platelet transfusion is commonly used to stop bleeding, and there are some cases where patients with thrombocytopenia require prophylactic platelet transfusion. So, in addition to platelet transfusion, how should bleeding be stopped in different parts? When bleeding gums, gelatin sponge dipped in thrombin and fibrinogen can be used locally to compress the bleeding site; antifibrinolytic preparations used locally or locally can be used as an auxiliary treatment for bleeding gums and tooth extraction. Nasal bleeding is sometimes difficult to control, you can try the following steps in order: raise the patient’s head and locally pressurize; use a cotton ball dipped in oxymetazoline and other vasoconstrictors; fill the nasal cavity to contract local blood vessels; use silver nitrate or trichloroacetic acid cauterization Hemorrhage; a large amount of gauze to fill the nasal cavity; if it still does not work, consider ligating or embolizing the internal jaw artery; when local treatment still can not control bleeding, platelet transfusion is performed. For patients with heavy menstruation, hormone therapy can be considered, and contraceptives can also play a good role. Because menstrual menstruation often causes severe bleeding and even requires emergency hysterectomy, some people think that it is necessary to perform hormone therapy before menarche; however, the possible bone developmental stagnation should also be considered. Furthermore, long-term chronic blood loss should supplement iron and folic acid. The above are some methods of hemostasis with different degrees of bleeding. Patients with thrombocytopenia and their families should understand and master. At the same time, appropriate treatment measures are taken according to their own conditions, active treatment, increase the platelet value, and avoid bleeding. More thrombocytopenia disease knowledge or patient help can pay attention to WeChat public number: xxbjs75

Why is the patient with cerebral infarction sent to the hospital, and the doctor just simply filmed the infusion? Read in one article

Many people think that the treatment of cerebral infarction in the hospital is actually very simple, that is, simple filming infusion, this is really a big misunderstanding! In fact, in addition to the lacunar cerebral infarction with mild symptoms, most acute cerebral infarctions need to be treated from the beginning of the hospital, including opening the venous channel, keeping the breathing smooth, oxygen inhalation, and electrocardiographic monitoring. For patients with acute cerebral infarction, time is equal to life, because it will directly affect the severity and prognosis of the patient’s condition. So why are many patients sent to the hospital, it will cause the family to the doctor to simply take a film and infusion? The following explains one by one. Regarding the imaging examination of brain tissue lesions by filming, brain CT and magnetic resonance (MRI) are the most commonly used examination methods. Patients with acute cerebral infarction usually undergo a CT scan of the brain immediately after admission. This is because on the one hand, the doctor needs to rule out cerebral hemorrhage and identify non-vascular lesions such as brain tumors. On the other hand, brain CT can help the doctor identify the location of the infarction And scope, to provide a basis for the next step of thrombolytic therapy. And because of the long MRI examination time, in order to fight for the golden treatment time, it is usually the first choice for brain CT examination. Regarding infusion, the layman seems to have a very simple infusion, but it is not that simple. First, if the patient is evaluated to meet the indications for intravenous thrombolysis, the contraindications to intravenous thrombolysis are excluded, and if the time window of intravenous thrombolysis includes 3h, 3-4.5h, and 6h after the onset, intravenous thrombolysis can be performed. Yes, the infusion at this time may be thrombolytic drugs. Secondly, infusion is also for the treatment of some acute complications. Since severe cerebral edema and increased intracranial pressure are common complications of acute severe cerebral infarction and one of the main causes of patient death, dehydration needs to be used according to the patient’s symptoms. Intravenous instillation of the drug can reduce cerebral edema and reduce intracranial pressure. In addition, some patients have hypotension after acute cerebral infarction. When actively searching for the cause, it is necessary to expand blood volume through infusion to maintain stable blood pressure when necessary. Because some patients with acute cerebral infarction have vomiting, difficulty swallowing, etc., fluid replacement and nutritional support treatment are also needed when necessary, which also needs to be supplemented by infusion. At present, many large tertiary general hospitals have stroke centers with standard procedures for the treatment of acute cerebral infarction. The treatment of acute cerebral infarction needs to race against time, and the treatment process has been accurate to how many minutes after the onset of the examination or what treatment method, so not everyone sees just taking a film and infusion. References: “Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China” (2018) (Part of the picture source network in the article, the copyright belongs to the original author, thank you for the picture author, if you find any violation of your copyright, Please contact me, I will delete.)

Hu Guisheng: After chemotherapy, how do family members accompany patients?

Assistant Hu Guisheng WeChat: dd326751 chemotherapy is one of the important means of leukemia treatment. Although today’s treatment continues to develop, it still has an irreplaceable role. However, during patient hospitalization or outpatient chemotherapy, family support also plays a very important role. Many patients will ask “whether there are leukemia patients at home, how should we take care of as family members”, “Does patients need to be accompanied by 24h when they hang water in the hospital”, and are there any dangers when patients hang chemotherapy water? Answer. They not only need care in life, but also need psychological and emotional support. In this regard, family companionship has an irreplaceable role for medical staff. For example, family members ’accompany can provide timely food, timely payment, answer questions, information advice, etc. , To help solve the various difficulties encountered by patients during chemotherapy. Secondly, the correct guidance and psychological support of family members can correct abnormal changes in mood and spirit, allowing patients to better cooperate with examinations and treatments, and family members ’accompany can also be reduced The feeling of loneliness and insecurity of patients with chemotherapy can make patients feel the warmth and care of Ai Ting, and give emotional satisfaction. At the same time, family members can help patients deal with the symptoms of chemotherapy (fatigue, weakness, muscles, etc.) and some daily life (Transportation, cleaning, personal care, etc.), also very good for the recovery of chemotherapy patients In addition to this, the family members can find the patients’ serious chemotherapy adverse reactions (acute allergies) in time during the patient’s chemotherapy, and can promptly notify the doctors and nurses for timely treatment. At least one family member must be accompanied when infusion. Instructed not to leave as much as possible, in case you have to leave, you must ask someone to help stare. & Nbsp. Try not to sit in the air-conditioning outlet in summer, try to wear long clothes, contact with cold objects (iron and metal), etc .; winter Do not sit in the aisle vents, pay attention to wearing masks, wool or cotton gloves and hats, and wearing warm clothes. During the infusion process, once urticaria, chest tightness, shortness of breath, flustered, blurred vision, sweating, severe nausea, vomiting, etc. Inform doctors and nurses of any uncomfortable allergic symptoms in time. & Nbsp.After the infusion, stay in a warm place for more than half an hour, go out tightly, do not blow cold air, eat cold drinks. & Nbsp.If you continue to use oxaliplatin in the next cycle Tell medical staff that an allergic reaction to the drug has occurred.

For patients with stroke, it is not recommended to use infusion of the affected limb

& nbsp. & nbsp. & nbsp. & nbsp. & nbsp. & nbsp. Early in the morning, the nurse nurse pushed the infusion drug cart into the ward, and he said to me, “Old Li, I need an intravenous infusion, please give me your right hand. “No, no, I want to hang it in my left hand.” As soon as I heard that the nurse was going to infusion in my right hand, I stopped him quickly. Looking at her puzzled expression, I hurriedly told him the reason: “This morning my wife and children have no time to take care of me. If the infusion is in the right hand, I will drink water later. What should I do? And my left hand does not If you can move the needle, you ca n’t move it. After that, my left hand and feet wo n’t move. Your medicine should be hung on your left hand to absorb it faster, do n’t you? ”The nurse smiled and said,“ You ’re wrong. By the way, stroke patients can no longer suffer from side infusion. The affected side infusion is a cause of shoulder-hand syndrome, and phlebitis and venous embolism are prone to occur. You see Lao Lin next door has been infusion on the affected side in the external hospital. Swollen shoulders and pain, don’t you want to be like him? “” Of course I don’t want to, but why does this happen? “Since I don’t know the reason, I had to break the casserole and ask. & nbsp. & nbsp. & nbsp. & nbsp. Fortunately, the nurse was very patient, she told me: ① Most patients will habitually lie on the side facing the infusion direction. At this time, the shoulder on the hemiplegic side will be pressed down. Neuromotor and peripheral neuropathy, the skeletal muscle of the body is relatively relaxed, the contraction ability is reduced, and the blood circulation of the side limb of hemiplegia is poor. If the shoulder is pressed for too long, the shoulder will numb and pain, which is the reason for the shoulder pain. ②When we exercise, we can cause the narrowing and relaxation of blood vessels and lymphatic vessels in the muscle gap, promote blood circulation, and raising the upper limbs will empty the blood of the back vein of the hand to prevent arm edema. However, during intravenous infusion, because the arm can not move for a long time, it will reduce the tension of the venous tube wall and reduce the squeezing effect on the vein, causing a large amount of venous blood to accumulate on the arm of the hemiplegic side and edema. In addition, the movement sensation on the side of hemiplegia is decreased, and the blood supply is insufficient. In the intravenous infusion, due to the action of various drugs, the blood vessels are stimulated, and the capillary permeability is increased, thereby increasing the occurrence of arm edema. ③ The blood of the affected limb is slow, the time that the drug stays in the local vein during the infusion is prolonged, and the vein wall damage caused by the puncture is prone to cause thrombophlebitis and venous embolism. After listening to the nurse’s explanation, I realized that I could not infusion on the affected side. After the needle was inserted, the nurse also placed the call bell on my right hand, making me call them in time when I wanted to drink water or eat, which solved my worries and allowed me to lie in bed infusion. & nbsp. & nbsp. Therefore, it is better to choose the healthy limb as much as possible for the infusion of stroke patients. For more medical science, please pay attention to the message!

Hu Guisheng: What are the positive effects of umbilical cord blood infusion for aplastic anemia?

Umbilical cord blood is the blood left in the placenta and umbilical cord after birth. In recent decades, studies have found that it is rich in hematopoietic stem cells, which can become a source of hematopoietic stem cell clinical transplantation. & nbsp. In order to find a new source of hematopoietic stem cells, we conducted a lot of experimental research on human cord blood. Experimental studies have shown that cord blood is not only rich in hematopoietic stem cells and hematopoietic factors, but also contains more mature red blood cells, white blood cells, and platelets. Compared with adult peripheral blood, there is a significant difference (P & lt.0.01 ~ 0.001). & nbsp. We have seen in clinical experiments that the first case is acute aplastic anemia. During the transfusion of umbilical cord blood, the peripheral blood and component blood were stopped. Not only did the condition not worsen, but hemoglobin, leukocytes and platelets gradually increased. Clinical symptoms and signs It gradually disappeared and achieved remission. It was cured without recurrence for more than 3 years of follow-up. The mechanism of umbilical cord blood treatment for aplastic anemia is not yet clear. We think it may be related to: & nbsp. 1. Cord blood infusion provides patients with a large number of hematopoietic stem / progenitor cells. Each 100ml of cord blood infusion can be supplemented by approximately 5.02X10 ^ 9 / LCD cells, 91.36X10 ^ 9 / LCD + 34 cells, the existing hematopoietic stem cells may be temporarily implanted, which has bought time for the reconstruction of his bone marrow hematopoietic function. It shows that after treatment, the bone marrow changes from low hyperplasia to active hyperplasia; & nbsp.2. Cord blood contains multiple hematopoietic factors, which is conducive to the proliferation, differentiation and maturity of cord blood hematopoietic stem cells; & nbsp.3. CFUF contained in cord blood improves The hematopoietic microenvironment; & nbsp.4. Cord blood cells have low immune activity, which is not easy to produce rejection reactions, and play a regulatory role in the body ’s immunity; & nbsp.5. Cord blood transfusion provides the body with more mature red blood cells and white blood cell platelets , Has played an active therapeutic role in correcting anemia, enhancing granulocyte phagocytosis, preventing infection and bleeding. & nbsp. & nbsp. Clinical application results show that cord blood can improve and restore the ability of bone marrow hyperplasia, reduce the symptoms of blood and infection, reduce and eliminate the dependence of anemia patients on blood transfusion, and the whole blood cell proliferation is more obvious than the control group. The length of time is proportional to the number and quantity of cord blood transfusions. Added a new effective treatment method for patients with aplastic anemia.

Can patients with thrombocytopenia use rituximab? What are the adverse reactions?

Rituximab (rituximab) is a murine / human chimeric monoclonal antibody that can specifically bind to transmembrane CD antigen and effectively eliminate abnormal B cell clones. The use of ITP patients is repeated infusion, and it will be recommended after the efficacy of the medication decreases. What are the adverse effects of (Merovar) drugs for patients with thrombocytopenia? According to clinical observation, it will be found that the most common time for the cytokine release syndrome is 1 to 2 hours after infusion of merova, which can be distinguished from the acute allergic reaction of merova. Allergic reactions are often rapid and occur in about 5 minutes. Fever with chills is the main adverse reaction! It is also a manifestation of cytokine release syndrome. The occurrence of this kind of situation requires timely treatment, and it will not affect the re-infusion of Merovar when it reaches control. However, focus on the point-if it is the acute allergic reaction of merova, it is another matter! If you have any questions about this article or your condition, follow the patient’s WeChat account to get help: xxbjs1

MDS transfusion dependence question, can it be directly transplanted?

Questions about blood transfusion dependence (can it be transplanted?) | When do MDS patients need blood transfusion? How many times can you lose? Myelodysplastic syndrome is a malignant hematological disease, there is invalid pathological hematopoiesis, and peripheral blood has one or more lines of blood cells reduced. According to the problem of blood transfusion dependence, protection needs to pay attention to anemia, bleeding, and infection. For this disease, there is currently no short-term direct and efficient cure in the clinic, so patients should not easily believe the secret recipe! The treatment plan needs to be personalized and the process is adjusted according to the change of the disease. The treatment is mainly based on immunomodulation, combination therapy, symptomatic support maintenance therapy and transplantation, and chemotherapy. The main therapeutic purpose of MDS is to improve the patient’s symptoms, reduce the risk of complications, prevent the disease or delay the conversion and occurrence of the disease to leukemia, with the purpose of improving the quality of life and prolonging survival. Regarding the problem of blood product transfusion, MDS patients are generally recommended to red blood cells when hemoglobin is less than 60g / L. The purpose is to improve hypoxic symptoms such as palpitation, shortness of breath, fatigue, and dizziness. Chronic bronchitis, emphysema, etc.) are particularly important. The amount of blood transfusion should not be too much every time, and it can be small and many times. When the platelet is less than 15-20 × 109 / L, it will be recommended to infusion of platelet suspension to prevent the serious consequences of hemorrhage of important organs, especially intracranial hemorrhage, which is one of the important causes of MDS death. The average lifespan of normal platelets is 8.0 ± 0.9 days, so the platelet transfusion can only be maintained for about a week, and some 5 to 6 days. Long-term repeated transfusion may produce the same kind of antibody and cause the transfusion to be invalid. It is called “ineffective transfusion”. “. MDS depends on blood transfusion, can it be transplanted directly? Regarding transplantation, because of the problem of blood transfusion dependence, it may have its own iron load and extreme failure inhibition of the hematopoietic microenvironment, including antibody problems. If these conditions exist, it is not suitable for transplantation. If you have any questions about this article or your condition, follow the patient’s WeChat account to get help: gsby120