维持性血液透析患者胸椎骨髓炎及动静脉内瘘障碍的护理

doi:10.3761/j.issn.2096-7446.2026.11.010

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1341-1343.doi: 10.3761/j.issn.2096-7446.2026.11.010

维持性血液透析患者胸椎骨髓炎及动静脉内瘘障碍的护理

胡碧碧(), 林剑靖^*()

浙江大学医学院附属第二医院护理部杭州市 310051

收稿日期:2025-11-29 出版日期:2026-11-10 发布日期:2026-11-06
通讯作者: *林剑靖，E-mail：2503043@zju.edu.cn
作者简介:胡碧碧：女，本科，主管护师，E-mail：2613366@zju.edu.cn
作者贡献声明
胡碧碧：研究实施、循证分析、论文撰写；林剑靖：研究指导及修改
基金资助:
浙江省中医药科技计划项目(2024ZL580)

Nursing care of a patient undergoing maintenance hemodialysis complicated with thoracic spondylitis and arteriovenous fistula dysfunction

HU Bibi(), LIN Jianjing^*()

Nursing Department， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310051， China.

Received:2025-11-29 Online:2026-11-10 Published:2026-11-06
Contact: *LIN Jianjing，E-mail：2503043@zju.edu.cn
Supported by:
Zhejiang Traditional Chinese Medicine Science and Technology Program(2024ZL580)

摘要/Abstract

摘要：

总结1例维持性血液透析患者并发胸椎骨髓炎及动静脉内瘘障碍的护理体会。针对患者感染控制难、血管通路维护复杂、并发症风险高等护理难点，在多学科团队协作下实施如下护理措施：基于微生物学证据的精准感染控制与胸椎术后伤口精细化管理；围绕内瘘狭窄与血栓形成的动态监测与应急处理；根据病情危重程度制订个体化透析方案；胸椎术后并发症的预警与抢救护理。患者住院第62天，感染得到控制，伤口愈合，动静脉内瘘功能恢复，康复出院。随访3个月，患者状况良好。

关键词: 血液透析滤过, 胸椎骨髓炎, 动静脉瘘, 多学科团队, 危重病护理

Abstract:

To summarize the nursing care of a patient undergoing maintenance hemodialysis who developed thoracic vertebral osteomyelitis and arteriovenous fistula dysfunction. Key challenges included difficulty of infection control，complicated vascular access maintenance，and high complication risks. Nursing measures under multidisci-plinary team collaboration included precision infection control based on microbiological evidence and refined management of post-thoracic surgery wounds，dynamic monitoring and emergency treatment for fistula stenosis and thrombosis，personalized dialysis plans based on the patient’s condition，and early detection and monitoring of postoperative complications. The patient was hospitalized for 62 days，with infection controlled，wound healed，and fistula function restored. The patient was discharged after rehabilitation，and the patient’s condition was stable during 3 months of follow-up.

Key words: Hemodiafiltration, Thoracic Vertebral Osteomyelitis, Arteriovenous Fistula, Multidisciplinary Team, Critical Care Nursing

胡碧碧, 林剑靖. 维持性血液透析患者胸椎骨髓炎及动静脉内瘘障碍的护理[J]. 中华急危重症护理杂志, 2026, 7(11): 1341-1343.

HU Bibi, LIN Jianjing. Nursing care of a patient undergoing maintenance hemodialysis complicated with thoracic spondylitis and arteriovenous fistula dysfunction[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(11): 1341-1343.

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维持性血液透析患者胸椎骨髓炎及动静脉内瘘障碍的护理

Nursing care of a patient undergoing maintenance hemodialysis complicated with thoracic spondylitis and arteriovenous fistula dysfunction

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