【摘要】 总结1例难治性血栓性血小板减少性紫癜（immune-mediated thrombotic thrombocytopenic purpura,iTTP）急性进展期患者的护理经验。护理重点包括：实施循证护理早期识别策略，驱动快速确诊；血浆置换联合应用利妥昔单抗期间的循证护理与安全管理；实施“四位一体”的神经康复策略，促进神经功能康复。经过23d的精心护理，患者实现临床缓解出院，随访恢复良好。更多还原

【Abstract】 This article reported the nursing experience in managing a patient with refractory immune-mediated thrombotic thrombocytopenic purpura in the acute phase. Key nursing interventions included: early identify evidence-based strategies and caredriven rapid diagnosis of thrombotic thrombocytopenic purpura （TTP）,evidence-based nursing and safety management during plasma exchange combined with rituximab,and apply a "four-in-one" neurological rehabilitation strategy to promote a recovery of neurological function. After 23 days of intensive treatment and meticulous nursing care,the patient achieved clinical remission with favourable outcomes over follow-up.更多还原