重度急性有机氟中毒继发心肺功能衰竭患者的护理

doi:10.3761/j.issn.2096-7446.2022.06.015

中华急危重症护理杂志 ›› 2022, Vol. 3 ›› Issue (6): 547-549.doi: 10.3761/j.issn.2096-7446.2022.06.015

重度急性有机氟中毒继发心肺功能衰竭患者的护理

王丽竹, 郭晶晶, 徐剑锋, 吴金晶, 余翔, 张瑞

310009 杭州市浙江大学医学院附属第二医院ICU（王丽竹,郭晶晶,吴金晶,余翔）,呼吸治疗科（徐剑锋）,急诊科（张瑞）

收稿日期:2021-12-04 出版日期:2022-11-10 发布日期:2022-11-11
作者简介:王丽竹：女,硕士,副主任护师,护士长,E-mail：zrwlz@zju.edu.cn
基金资助:
浙江省教育厅项目（Y201941204）

Nursing care of a patient with cardiopulmonary failure secondary to acute severe organic fluorosis

WANG Lizhu, GUO Jingjing, XU Jianfeng, WU Jinjing, YU Xiang, ZHANG Rui

Received:2021-12-04 Online:2022-11-10 Published:2022-11-11

摘要/Abstract

摘要： 总结1例重度急性有机氟气体中毒继发心肺功能衰竭患者的护理体会。针对本例患者低氧血症、中毒性肺水肿、心肺功能衰竭等主要问题,采取了积极控制中毒性肺水肿、精准化气道管理、早期肺康复、心肺保护策略等主要措施。经积极救治、精心护理,患者于入院后第27天步行出院。

关键词: 气体中毒, 肺康复, 体外膜肺氧合, 连续性肾脏替代疗法, 急症护理

Abstract: To summarize the nursing process of a patient with acute severe organic fluorine gas poisoning. Aimed at the main problems of this patient such as hypoxemia,toxic pulmonary edema,cardiopulmonary failure,we have adopted measures such as active control of toxic pulmonary edema,precise airway management,effective pulmonary rehabilitation,and cardiopulmonary protection strategies. After active treatment and meticulous care,the patient was discharged on the 27th day after admission.

Key words: Gas Poisoning, Pulmonary Rehabilitation, Extracorporeal Membrane Oxygenation, Continuous Renal Replacement Therapy, Emergency Nursing

王丽竹, 郭晶晶, 徐剑锋, 吴金晶, 余翔, 张瑞. 重度急性有机氟中毒继发心肺功能衰竭患者的护理[J]. 中华急危重症护理杂志, 2022, 3(6): 547-549.

WANG Lizhu, GUO Jingjing, XU Jianfeng, WU Jinjing, YU Xiang, ZHANG Rui. Nursing care of a patient with cardiopulmonary failure secondary to acute severe organic fluorosis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(6): 547-549.

参考文献

[1] 卫生部. 中华人民共和国国家职业卫生标准:职业性急性有机氟中毒诊断标准GBZ 66—2002[S]. 北京:法律出版社,2004.
Ministry of Health. Professional Health Standard of the People's Republic of China:Diagnostic criteria of occupational acute fluorohydrocarbon poisoning. GBZ 66—2002[S]. Beijing:Law Press,2004.
[2] Giacomo B,John GL,Tài P,et al.Epidemiology,patterns of care,and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries[J]. JAMA,2016,315(8):788-800.
[3] 许伟,王小红,夏春娟,等. 经鼻高流量氧疗在急性群发性窒息性气体中毒合并肺大疱治疗中的应用[J]. 中华劳动卫生职业病杂志,2020,38(10):757-759.
Xu W,Wang XH,Xia CJ,et al.Application of nasal high flow oxygen therapy in acute mass asphyxia poisoning with pulmonary bullae[J]. Chin J Ind Hyg Occup Dis,2020,38(10):757-759.
[4] 中国医师协会急诊医师分会,中国急诊专科医联体,中国医师协会急救复苏和灾难医学专业委员会,等. 刺激性气体中毒诊治专家共识[J]. 中华急诊医学杂志,2020,29(12):1527-1536.
Emergency Physician Branch of Chinese Medical Association,China Emergency Medical Association,Emergency Resuscitation and Disaster Medicine Committee of Chinese Medical Doctor Association,et al. Expert consensus on diagnosis and treatment of irritant gas poisoning[J]. Chin J Emerg Med,2020,29(12):1527-1536.
[5] 中华医学会呼吸病学分会介入呼吸病学学组. 成人诊断性可弯曲支气管镜检查术应用指南(2019年版)[J]. 中华结核和呼吸杂志,2019,42(8):573-590.
Interventional Respiratory Medicine Group of Respiratory Diseases Branch of Chinese Medical Association. Adult diagnostic flexible bronchoscopy guidelines(2019 edition)[J]. Chin J Tuberc Respir Dis,2019,42(8):573-590.
[6] Hashemian SM,Mortaz E,Jamaati H,et al.Budesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients:association with inflammatory mediators and cells[J]. J Crit Care,2018,44:161-167.
[7] 路卫,夏照帆,陈旭林. 吸入性损伤后预防性气管切开与紧急气管切开的临床研究[J]. 中华烧伤杂志,2003,19(4):233-235.
Lu W,Xia ZF,Chen XL.Clinical study on the comparison of prophylactic with emergent tracheostomy after inhalation injury[J]. Chin J Burn,2003,19(4):233-235.
[8] Matsui H,Jo T,Fushimi K,et al.Outcomes after early and delayed rehabilitation for exacerbation of chronic obstructive pulmonary disease:a nationwide retrospective cohort study in Japan[J]. Respir Res,2017,18(1):68.
[9] 中华医学会重症医学分会重症呼吸学组. 急性呼吸窘迫综合征患者俯卧位通气治疗规范化流程[J]. 中华内科杂志,2020,59(10):781-787.
Critical Respiratory Group of Critical Care Medicine Branch of Chinese Medical Association. Standardized protocol of prone position ventilation in patients with acute respiratory distress syndrome[J]. Chin J Intern Med,2020,59(10):781-787.
[10] 刘西花,李晓旭,毕鸿雁,等. 中医康复临床实践指南·心肺康复[J]. 康复学报,2020,30(4):259-265,269.
Liu XH,Li XX,Bi HY,et al.Clinical practice guidelines of traditional Chinese medicine rehabilitation for cardiopulmonary[J]. Rehabil Med,2020,30(4):259-265,269.
[11] 陈凯,唐汉韡,侯剑峰,等. 体外膜肺氧合在心脏外科领域的应用[J]. 中国循环杂志,2019,34(12):1244-1248.
Chen K,Tang HW,Hou JF,et al.Application of extracorporeal membrane oxygenation in cardiac surgery[J]. Chin Circ J,2019, 34(12):1244-1248.

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重度急性有机氟中毒继发心肺功能衰竭患者的护理

Nursing care of a patient with cardiopulmonary failure secondary to acute severe organic fluorosis

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