椎动脉支架术后并发延髓梗死伴贲门黏膜撕裂患者的护理

doi:10.3761/j.issn.2096-7446.2026.09.014

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (9): 1112-1114.doi: 10.3761/j.issn.2096-7446.2026.09.014

椎动脉支架术后并发延髓梗死伴贲门黏膜撕裂患者的护理

丁杨(), 庄一渝^*(), 黄瑞盈, 叶姗

浙江大学医学院附属邵逸夫医院护理部杭州市 310016

收稿日期:2025-09-20 出版日期:2026-09-10 发布日期:2026-08-31
通讯作者: *庄一渝，E-mail：zhuangyy@zju.edu.cn
作者简介:丁杨：女，硕士，副主任护师，E-mail：dingy2@srrsh.com
作者贡献声明
丁杨：论文撰写；庄一渝：研究指导；黄瑞盈：论文修改；叶姗：采集数据

Nursing care of a patient with medullary infarction complicated by Mallory-Weiss tear following vertebral artery stenting

DING Yang(), ZHUANG Yiyu^*(), HUANG Ruiying, YE Shan

Nursing Department， Sir Run Run Shaw Hospital，Zhejiang University School of Medicine， Hangzhou 310016， China

Received:2025-09-20 Online:2026-09-10 Published:2026-08-31
Contact: * ZHUANG Yiyu，E-mail：zhuangyy@zju.edu.cn

摘要/Abstract

摘要：

总结1例椎动脉支架术后并发延髓梗死伴贲门黏膜撕裂患者的护理体会。针对患者同时面临延髓梗死所致神经功能恶化与抗栓治疗背景下贲门黏膜撕裂引发致命性出血这一核心矛盾，采取如下护理措施：预警式识别延髓梗死与系统化神经功能监测；中西医结合降逆止呕，综合管理贲门黏膜撕裂；渐进式重启动态权衡下的抗栓方案；风险导向下的阶梯式营养支持与吞咽摄食管理。经过16 d治疗与护理，患者顺利出院，随访恢复良好。

关键词: 椎动脉, 支架植入术, 延髓梗死, 贲门黏膜撕裂, 危重病护理

Abstract:

To summarize the nursing experience of a patient who developed medullary infarction accompanied by Mallory-Weiss tear after vertebral artery stenting. Faced with the core challenge of balancing the risk of neurological deterioration from medullary infarction against the threat of fatal bleeding from the mucosal tear under antithrombotic therapy，nursing interventions were implemented，including systematic neurological monitoring for early warning of medullary infarction，integrated management of the Mallory-Weiss tear combining Chinese and Western medicine for antiemesis，stepwise and dynamically-balanced resumption of antithrombotic therapy，and risk-orientated phased nutritional support and swallowing management. After 16 days of treatment and nursing care，the patient was successfully discharged with good recovery during follow-up.

Key words: Vertebral Artery, Stent Implantation, Medullary Oblongata Infarction, Mallory-Weiss Tear, Critical Care Nursing

丁杨, 庄一渝, 黄瑞盈, 叶姗. 椎动脉支架术后并发延髓梗死伴贲门黏膜撕裂患者的护理[J]. 中华急危重症护理杂志, 2026, 7(9): 1112-1114.

DING Yang, ZHUANG Yiyu, HUANG Ruiying, YE Shan. Nursing care of a patient with medullary infarction complicated by Mallory-Weiss tear following vertebral artery stenting[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(9): 1112-1114.

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椎动脉支架术后并发延髓梗死伴贲门黏膜撕裂患者的护理

Nursing care of a patient with medullary infarction complicated by Mallory-Weiss tear following vertebral artery stenting

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