Pathogenesis:
1, thrombocytopenia: chemotherapy drugs and malignant tumors damage hematopoietic stem cells or affect their proliferation in bone marrow.
2. Too many platelets are destroyed.
3. Platelets stay in the spleen too much.
Clinical manifestations:
Bleeding of skin, mucosa and viscera. Platelet count is lower than 100 109/L, and severe platelet count is lower than 20109/l.
Principles of treatment
1, absolutely rest.
2. Stop taking drugs, especially drugs that reduce platelet count and inhibit platelet function, to avoid bone marrow suppression.
3, thrombocytopenia is mainly to prevent bleeding, the application of hematopoietic growth factor and platelet transfusion. Cytokines IL- 1 1 and thrombopoietin (TPO) can significantly shorten the time of thrombocytopenia after chemotherapy, which can be considered when the platelet is below 40 60 109/L and may continue to decline. When platelets are lower than 20 40 109/L and tend to bleed, platelets should be infused in addition to IL- 1 1 and TPO.
4, severe bleeding can be given hemostatic drugs, glucocorticoid.
preventive measure
1, wear soft, cotton underwear and avoid bathing with irritating soap;
2. It is best for male patients to use an electric razor to avoid skin wounds;
3. Use a soft brush when brushing your teeth to avoid bleeding gums;
4. Avoid eating rough and hard food.
Nursing measures
1, pay attention to check the skin for petechiae and ecchymosis, the location and time of occurrence, and whether there is bleeding in digestive tract and respiratory tract;
2. Try not to inject drugs that can be taken orally. If injection is needed, the needle eye is usually pressed with a cotton ball until the bleeding stops. Especially when the platelet is 1.0 109/L, the blood vessel must be compressed for 2 4 minutes after the infusion is completed and the needle is pulled out.
3. Apply paraffin oil locally to prevent chapped bleeding of oral and nasal mucosa.