Abstract:

This paper summarized the nursing experience of a patient with Evans syndrome complicated by herpes zoster，hepatorenal dysfunction，electrolyte and coagulation disorders，oral blood blisters，and a high bleeding risk. Key nursing interventions included：establishing a nurse-led integrated dynamic grading nursing model；implementing integrated dynamic grading nursing for bidirectional bleeding and thrombosis risk；providing mucocutaneous wound care for oral blood blisters and herpes zoster lesions；conducting early warning nursing for hemolytic crisis and airway asphyxia risk；performing sequential multiorgan protection and internal environment regulation nursing；and delivering psychological support nursing for critical illness of a rare hematologic disease. Following active treatment and individualized nursing care，the patient was discharged from the hospital after 26 days of hospitalization.

Key words: Evans Syndrome, Herpes Zoster, Multiorgan Dysfunction, High Bleeding Risk, Nursing Care

摘要：

该文总结了1例埃文斯综合征合并带状疱疹、肝肾功能不全、电解质及凝血功能紊乱、口腔血疱及高危出血患者的护理经验。护理要点：构建由护士主导的一体化动态分级护理模式、实施出血-血栓双向风险的一体化动态分级护理、口腔血疱与带状疱疹的黏膜及皮肤创面护理、溶血危象与窒息风险的早期预警护理、多器官功能损伤的序贯保护与内环境调控护理及罕见血液病危重期的心理支持护理。经积极治疗与个体化护理，患者住院26 d后康复出院。

关键词: 埃文斯综合征, 带状疱疹, 多器官功能损害, 高危出血风险, 护理