RESUMO
Activated phosphoinositide 3-kinase δ syndrome(APDS) is an autosomal dominant inherited primary immunodeficiency disease that is caused by mutations in PIK3CD or PIK3R1 genes leading to overactivation of the PI3Kδ signaling pathway, first reported by Angulo et al in 2013. The clinical manifestations of the disease are recurrent respiratory tract infections, benign lymph node hyperplasia, autoimmune diseases, lymphoma and so on. Although most patients develop the disease in childhood, there are also reports of adult onset and asymptomatic patients. In addition, the immunophenotype of activated phosphoinositide 3-kinase δ syndrome is changeable, usually the IgA levels are reduced, the IgM levels can be normal or elevated, and the IgG levels are variable, so it is easy to be misdiagnosed at first diagnosis. There is no unified diagnostic standard at present, and timely genetic testing is required to confirm the diagnosis.
RESUMO
Objective:To investigate the effect of Caprini risk score-based care on the prevention of venous thromboembolism of patients with major orthopedic surgery.Methods:Totally 124 patients with major orthopedic surgery were randomly divided into experimental group and control group, each group contained 62 cases. The control group received routine thrombosis prevention nursing, patients in the experimental group carried out Caprini risk score-based intervention. The rate of VTE was compared between two groups, the levels of D-Dimer as well as thigh circumference was measured after 24 hours of admission, 3 days after surgery, 5 days after surgery and at discharge day. At discharge day, the inpatients satisfaction with nursing service scale was used to assessment the satisfaction with nursing service of inpatients.Results:The rate of VTE in the experimental group was 1.6% (1/62) and 6.5% (4/62) in the control group, the difference was not statistically significant ( χ2 value was 1.876, P=0.171). Three days after surgery, 5 days after surgery and at discharge day, the D-Dimer were (1.26±0.65) μg/ml, (1.27±0.35) μg/ml, (0.96±0.27) μg/ml in the experimental group, 5 days after surgery and at discharge day, the thigh circumference were (29.81±4.15) cm, (28.86±3.40) cm in the experimental group, significantly lower than those in the control group [(1.64±0.58) μg/ml, (1.51±0.55) μg/ml, (1.25±0.44) μg/ml, (31.84±5.22) cm, (30.83±3.91) cm], the difference was statistically significant ( t value was 2.405-4.485, P<0.05). The health education and guidance, personality traits, service quality, discharge guidance scores and total satisfaction scores were 26.31±3.06, 35.73±3.64, 27.89±3.11, 8.47±1.18 and 111.08±6.33, significantly higher than those in the control group (24.15±2.31, 33.92±2.66, 26.27±3.41, 7.42±1.82 and 106.52±5.85), the difference was statistically significant ( t value was 2.750-4.433, P<0.05). Conclusions:Caprini risk score-based nursing care significantly alleviates the hypercoagulable states and relieves the degree of swelling of the affected of patients with major orthopedic surgery, as well as improves patients' satisfaction with nursing work.