多瘤病毒脑干脑炎伴精神症状患者血浆置换期间行分级身体约束的护理

doi:10.3761/j.issn.2096-7446.2026.10.012

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (10): 1222-1225.doi: 10.3761/j.issn.2096-7446.2026.10.012

多瘤病毒脑干脑炎伴精神症状患者血浆置换期间行分级身体约束的护理

郭湘¹(), 陈巧玲², 伍永佳¹, 朱宣静¹, 李苗³, 刘芳³^,^*()

¹ 福建医科大学护理学院福州市 350004
² 福州大学附属省立医院重症医学科1区福州市 350001
³ 首都医科大学宣武医院神经内科北京市 100053

收稿日期:2025-10-24 出版日期:2026-10-10 发布日期:2026-10-14
通讯作者: *刘芳，E-mail：liufangbeijing@sina.com
作者简介:郭湘：女，本科（硕士在读），E-mail：2454564662@qq.com
作者贡献声明
郭湘、伍永佳、朱宣静：循证分析、论文撰写；陈巧玲、李苗：资料收集、研究实施、论文撰写、经费支持；刘芳：研究指导、论文修改

Nursing care of graded physical restraint in a patient with psychiatric symptoms due to polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange

GUO Xiang¹(), CHEN Qiaoling², WU Yongjia¹, ZHU Xuanjing¹, LI Miao³, LIU Fang³^,^*()

¹ School of Nursing， Fujian Medical University， Fuzhou 350000， China
² Third Department of Critical Care Medicine， Fujian Provincial Hospital Affiliated to Fuzhou University， Fuzhou 350001， China
³ Department of Neurology， Xuanwu Hospital，Capital Medical University， Beijing 100053， China

Received:2025-10-24 Online:2026-10-10 Published:2026-10-14
Contact: *LIU Fang，E-mail：liufangbeijing@sina.com

摘要/Abstract

摘要：

总结1例多瘤病毒脑干脑炎伴精神症状患者血浆置换期间行分级身体约束的护理体会。护理要点：针对患者精神行为异常、镇静效果不佳及治疗配合度低等护理难点，护理团队在血浆置换前构建“基于风险评估的分级化身体约束策略”，在血浆置换过程中严格落实分级化身体约束管理，血浆置换治疗间歇期优先考虑身体约束替代策略，治疗全程未出现非计划性拔管，治疗完成率100%，且未出现身体约束相关并发症。ICU监护治疗21 d后，患者四肢远端肌力明显改善，格拉斯哥评分恢复至15分，意识清醒，转至神经内科普通病房继续治疗。

关键词: 脑炎, 精神症状, 血浆置换, 分级化身体约束, 危重病护理

Abstract:

To summarize the nursing experience of a patient with psychiatric symptoms caused by polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange（TPE） with graded physical restraint. To address challenges such as patients’ psychiatric behavioral abnormalities，suboptimal sedation efficacy，and low treatment compliance，the nursing team established a risk-assessment-based graded physical restraint strategy before plasma exchange. During the procedure，we strictly implemented graded physical restraint management，while prioritizing alternative restraint strategies during the treatment interval. No unplanned extubation occurred during the entire treatment process，with a 100% treatment completion rate and no complications related to physical restraints. After 21 days of ICU monitoring and treatment，the patient’s distal limb muscle strength improved，with the Glasgow score restored to 15 points，and regained consciousness. The patient was then transferred to the general ward of the neurology department for further treatment.

Key words: Encephalitis, Psychiatric Symptoms, Plasma Exchange, Graded Physical Restraint, Critical Care Nursing

郭湘, 陈巧玲, 伍永佳, 朱宣静, 李苗, 刘芳. 多瘤病毒脑干脑炎伴精神症状患者血浆置换期间行分级身体约束的护理[J]. 中华急危重症护理杂志, 2026, 7(10): 1222-1225.

GUO Xiang, CHEN Qiaoling, WU Yongjia, ZHU Xuanjing, LI Miao, LIU Fang. Nursing care of graded physical restraint in a patient with psychiatric symptoms due to polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(10): 1222-1225.

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多瘤病毒脑干脑炎伴精神症状患者血浆置换期间行分级身体约束的护理

Nursing care of graded physical restraint in a patient with psychiatric symptoms due to polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange

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