ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (8): 957-959.doi: 10.3761/j.issn.2096-7446.2025.08.009

• 急症护理研究 • 上一篇    下一篇

重度肥胖患者严重创伤后合并急性呼吸窘迫综合征的护理

张晶(), 王丽竹, 黄晓霞, 封秀琴()   

  1. 310009 杭州市 浙江大学医学院附属第二医院麻醉监护室(张晶),急诊监护室(黄晓霞),护理部(封秀琴,王丽竹)
  • 收稿日期:2025-02-18 出版日期:2025-08-10 发布日期:2025-08-12
  • 通讯作者: 封秀琴,E-mail:fengxiuqin@zju.edu.cn
  • 作者简介:张晶:女,本科(硕士学位),主管护师,责任组长,E-mail:zezhangjing@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技计划项目(2018KY417)

Nursing care of a severely obese patient with acute respiratory distress syndrome after severe trauma

ZHANG Jing(), WANG Lizhu, Huang Xiaoxia, FENG Xiuqin()   

  • Received:2025-02-18 Online:2025-08-10 Published:2025-08-12

摘要:

总结1例重度肥胖患者严重创伤后合并急性呼吸窘迫综合征的护理体会。护理要点:针对患者多发创伤引起的剧烈疼痛、严重氧合障碍、俯卧位通气限制、营养不良及感染等问题,采取分阶段镇静镇痛、体外膜肺氧合联合阶梯式侧卧、局部间歇凌空减压、腹内压导向肠内营养,以及数智化技术感控闭环等护理措施。通过多学科协同救治与技术创新,患者经49 d个体化护理后转康复医院;随访5个月显示恢复良好。

关键词: 呼吸窘迫综合征, 多处创伤, 肥胖症, 体外膜氧合作用, 危重病护理

Abstract:

To summarize the nursing experience of a severely obese patient with acute respiratory distress syndrome(ARDS) after severe trauma. Key interventions addressed multiple challenges,including severe pain,refractory hypoxemia,contraindications to prone positioning,malnutrition,and infection risks. The phased sedation-analgesia,extracorporeal membrane oxygenation(ECMO) support with stepwise lateral positioning,localized intermittent pressure offloading,intra-abdominal pressure-directed enteral nutrition,and digitalized infection control were adopted. Through multidisciplinary collaborative treatment and technological innovation,the patient was transferred to rehabilitation hospital successfully after 49 days of individualized care,and 5-month follow-up showed good recovery.

Key words: Respiratory Distress Syndrome, Multiple Trauma, Obesity, Extracorporeal Membrane Oxygenation, Critical Care Nursing