下肢感染创伤弧菌致坏死性筋膜炎患者成功保肢的护理

doi:10.3761/j.issn.2096-7446.2026.11.009

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1337-1340.doi: 10.3761/j.issn.2096-7446.2026.11.009

下肢感染创伤弧菌致坏死性筋膜炎患者成功保肢的护理

蔡晓婷(), 祁海鸥, 徐欣, 王新安, 王宝香, 赵林芳^*()

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:2026-01-26 出版日期:2026-11-10 发布日期:2026-11-06
通讯作者: *赵林芳，E-mail：3193159@zju.edu.cn
作者简介:蔡晓婷：女，本科（硕士在读），主管护师，E-mail：3413057@zju.edu.cn
作者贡献声明
蔡晓婷：构思设计、论文撰写；祁海鸥、徐欣：论文审校；王新安：论文修订；王宝香：资料收集、整理；赵林芳：论文指导及修改

Nursing of successfully preserving the lower limb of a patient with necrotizing fasciitis caused by Vibrio vulnificus infection

CAI Xiaoting(), QI Haiou, XU Xin, WANG Xinan, WANG Baoxiang, ZHAO Linfang^*()

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

Received:2026-01-26 Online:2026-11-10 Published:2026-11-06
Contact: *ZHAO Linfang，E-mail：3193159@zju.edu.cn

摘要/Abstract

摘要：

总结1例下肢感染创伤弧菌致坏死性筋膜炎患者成功保肢的护理体会。护理要点：基于5G数智化平台进行院前指导，实施早期目标导向液体复苏；分阶段疼痛评估，缓解患肢疼痛；加强患肢局部监测与护理，同时预防深静脉血栓形成；给予个体化创面护理，促进愈合控制感染；评估患者代谢需求，落实营养支持方案；渐进式抗阻训练，促进肢体功能恢复。经过48 d精心治疗与护理，患者保肢成功，出院后随访3个月，患者肢体功能恢复良好。

关键词: 创伤弧菌, 筋膜炎, 坏死性, 感染性休克, 保肢, 危重病护理

Abstract:

To summarize the nursing experience of successfully preserving the lower limb of a patient with necrotizing fasciitis caused by Vibrio vulnificus infection. Pre-hospital guidance was provided based on a 5G digital and intelligent platform，and early goal-directed fluid resuscitation was implemented. Staged pain assessment was conducted to alleviate pain in the affected limb. Monitoring and care of the affected limb were strengthened to prevent deep vein thrombosis. Individualized wound care was given to promote healing and control infection. The patient’s metabolic needs were assessed，and nutritional support was implemented. Gradual resistance training was conducted to facilitate the recovery of limb function. After 48 days of meticulous treatment and nursing，the patient’s limb was successfully preserved，and he was discharged. Follow-up for 3 months after discharge showed that the patient’s limb function had recovered well.

Key words: Vibrio Vulnificus, Fasciitis, Necrotizing, Neptic Shock, Limb Preserve, Critical Care Nursing

蔡晓婷, 祁海鸥, 徐欣, 王新安, 王宝香, 赵林芳. 下肢感染创伤弧菌致坏死性筋膜炎患者成功保肢的护理[J]. 中华急危重症护理杂志, 2026, 7(11): 1337-1340.

CAI Xiaoting, QI Haiou, XU Xin, WANG Xinan, WANG Baoxiang, ZHAO Linfang. Nursing of successfully preserving the lower limb of a patient with necrotizing fasciitis caused by Vibrio vulnificus infection[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(11): 1337-1340.

参考文献 14

[1]	中华预防医学会. 创伤弧菌感染诊治、预防专家共识[J]. 中华流行病学杂志, 2025, 46(7):1142-1149.
	Chinese Preventive Medicine Association. Expert consensus on diagnosis,treatment and prevention of Vibrio vulnificus infection[J]. Chin J Epidemiol, 2025, 46(7):1142-1149.
[2]	Allaw F, Wehbe S, Kanj SS. Necrotizing fasciitis:an update on epidemiology,diagnostic methods,and treatment[J]. Curr Opin Infect Dis, 2024, 37(2):105-111.
[3]	中华医学会烧伤外科学分会, 《中华烧伤与创面修复杂志》编辑委员会, 中国医疗保健国际交流促进会烧伤医学分会. 成人坏死性筋膜炎诊治专家共识(2025版)[J]. 中华烧伤与创面修复杂志, 2025, 41(7):613-627.
	Chinese Burn Association, Editorial Committee of Chinese Journal of Burns and Wounds, Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare. Consensus on the diagnosis and treat-ment of adult necrotizing fasciitis(2025 Edition)[J]. Chin J Burns Wounds, 2025, 41(7):613-627.
[4]	陈幼丽, 魏思灿, 李才辉, 等. 创伤弧菌坏死性筋膜炎的研究进展[J]. 临床皮肤科杂志, 2024, 53(8):507-510.
	Chen YL, Wei SC, Li CH, et al. Necrotizing fasciitis caused by Vibrio vulnificus[J]. J Clin Dermatol, 2024, 53(8):507-510.
[5]	Fujishima C, Matsuoka Y, Kinoshita H, et al. Epidemiology and early surgical intervention in necrotizing fasciitis:a retrospec-tive cohort study in japan[J]. J Dermatol, 2025, 52(7):1175-1184.
[6]	中国医师协会急救复苏和灾难医学专业委员会, 中国研究型医院学会休克与脓毒症专业委员会, 中国医疗保健国际交流促进会急诊医学分会, 等. 创伤弧菌脓毒症临床诊治急诊专家共识[J]. 中华急诊医学杂志, 2025, 34(2):163-172.
	Chinese Medical Doctors Association,Committee on Shock and Sepsis, Chinese Research Hospital Association,Society of Emer-gency Medicine, China International Exchange and Promotion Association for Medical and Health Care, et al. Expert con-sensus on the emergency clinical diagnosis and treatment of vibrio vulnificus sepsis,committee on emergency and disaster medicine[J]. Chin J Emerg Crit Care Nurs, 2025, 34(2):163-172.
[7]	Tebe PI, Wen GJ, Li J, et al. 5G-enabled medical data trans-mission in mobile hospital systems[J]. IEEE Internet Things J, 2022, 9(15):13679-13693.
[8]	葛晓静, 唐佳琪, 潘怡, 等. 基于目标导向疗法的早期液体复苏管理对重症急性胰腺炎患者预后的影响[J]. 国际护理学杂志, 2025, 44(17):3092-3096.
	Ge XJ, Tang JQ, Pan Y, et al. Impact of early goal-directed fluid resuscitation management on the prognosis of patients with severe acute pancreatitis[J]. Int J Nurs, 2025, 44(17):3092-3096.
[9]	急诊创伤疼痛管理共识专家组. 急诊创伤疼痛管理专家共识[J]. 中华急诊医学杂志, 2022, 31(4):436-441.
	Expert Consensus Group on Emergency Trauma Pain Manage-ment. Expert consensus on emergency trauma pain management[J]. Chin J Emerg Med, 2022, 31(4):436-441.
[10]	Alotni M, Fernandez R, Sim J, et al. Nurses’ readiness to im-plement the critical-care pain observation tool in the inten-sive care unit-instrument adaptation and psychometric analy-sis[J]. Pain Manag Nurs, 2025, 26(4):e353-e359.
[11]	Gregoire C, Charier D, de Bergeyck R, et al. Comparison bet-ween pupillometry and numeric pain rating scale for pain assessments in communicating adult patients in the emerge-ncy department[J]. Eur J Pain, 2023, 27(8):952-960.
[12]	余红梅, 潘红英, 占玉芬, 等. 全院联动静脉血栓形成防治信息化体系的建立与实践[J]. 中华护理杂志, 2020, 55(3):373-378.
	Yu HM, Pan HY, Zhan YF, et al. Establishment and practice of a hospital information system of prevention and treatment for venous thromboembolism[J]. Chin J Nurs, 2020, 55(3):373-378.
[13]	Keenan C, Obaidi N, Neelon J, et al. Negative pressure wound therapy:challenges,novel techniques,and future perspectives[J]. Adv Wound Care, 2025, 14(1):33-47.
[14]	Preston JD, Wagner VE, Galloway JR, et al. Hypocaloric feed-ing in critically ill trauma patients:A scoping review of the literature[J]. J Trauma Acute Care Surg, 2025, 99(5):804-817.

[1]	钟晨晨, 张丽萍, 文佳祺, 叶燕, 刘于. 成人心肌炎患者症状体验及多维度应对的质性研究[J]. 中华急危重症护理杂志, 2026, 7(9): 1096-1100.
[2]	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.
[3]	胥喆, 俞超, 伍潇丽. 双侧颈内静脉血栓患者PICC置管中行磁导航联合心腔内心电技术的护理配合[J]. 中华急危重症护理杂志, 2026, 7(9): 1150-1152.
[4]	胥喆, 徐红霞, 封凤, 谢睿, 王飞霞. 右上肢PICC置管患者孤立性永存左上腔静脉的识别及风险管理[J]. 中华急危重症护理杂志, 2026, 7(8): 976-978.
[5]	马燕欣, 王国英, 虎于丁, 刘会玲. BAG3基因突变致肌原纤维肌病患者机械通气脱机困难的肺康复护理[J]. 中华急危重症护理杂志, 2026, 7(8): 982-985.
[6]	杨莉, 徐晓滨, 王华芬. 功能性近红外光谱在急危重症患者护理中的应用进展[J]. 中华急危重症护理杂志, 2026, 7(7): 836-840.
[7]	柳小婷, 王萍, 徐亦虹, 范婷婷, 付真真, 熊子菡, 何蓓蕾, 陈晓晖, 章晓明, 舒妍. 巨结肠类缘病术后并发超短肠综合征伴多造口患者的护理[J]. 中华急危重症护理杂志, 2026, 7(7): 849-851.
[8]	邵丽红, 李春艳, 董晓琪, 王巧琳, 叶国凤, 赵巧梅. 口腔多原发癌患者游离皮瓣移植术后多重严重并发症的护理[J]. 中华急危重症护理杂志, 2026, 7(7): 852-855.
[9]	张慧, 何雪花, 王莉, 宫晓艳, 庄一渝. 边缘供心心脏移植术后患者原发性移植物功能障碍的早期预警与护理[J]. 中华急危重症护理杂志, 2026, 7(6): 682-684.
[10]	曾妃. 家族性肥厚型心肌病合并肝功能衰竭患者行心肝同期联合移植的护理[J]. 中华急危重症护理杂志, 2026, 7(6): 685-688.
[11]	羊木英, 范文琪, 胡汉. 维持性血液透析患者透析中脑出血的早期识别与急救护理[J]. 中华急危重症护理杂志, 2026, 7(6): 704-706.
[12]	庄佳妮, 李小珍, 史超强, 王英, 谭丽萍. 颈深部感染致纵隔脓肿患者的围手术期护理[J]. 中华急危重症护理杂志, 2026, 7(6): 707-709.
[13]	李改乐, 潘文彦, 李菁菁, 刘霄, 唐颖嘉, 侯进. 肝移植患者术后并发耶氏肺孢子菌与巨细胞病毒感染的护理[J]. 中华急危重症护理杂志, 2026, 7(6): 710-713.
[14]	王燕, 卢芳燕, 刘元, 王芳. 进行性家族性肝内胆汁淤积症患儿行亲体肝移植的术后护理[J]. 中华急危重症护理杂志, 2026, 7(6): 714-716.
[15]	万珊珊, 陈理华, 诸纪华. 新生儿坏死性小肠结肠炎肠造口术后高流量肠瘘预防及护理的最佳证据总结[J]. 中华急危重症护理杂志, 2026, 7(5): 554-560.

下肢感染创伤弧菌致坏死性筋膜炎患者成功保肢的护理

Nursing of successfully preserving the lower limb of a patient with necrotizing fasciitis caused by Vibrio vulnificus infection

RichHTML

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

参考文献 14

相关文章 15

编辑推荐

Metrics

本文评价