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

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (9): 1097-1099.doi: 10.3761/j.issn.2096-7446.2025.09.012

• 重症护理研究 • 上一篇    下一篇

腹膜透析患者胸腹瘘的早期识别及围手术期护理

孙淼娟(), 何佩佩(), 项世龙, 胡丽君   

  1. 310003 杭州市 浙江大学医学院附属第一医院护理部
  • 收稿日期:2024-10-23 出版日期:2025-09-10 发布日期:2025-09-02
  • 通讯作者: 何佩佩 E-mail:1712031@zju.edu.cn;1505044@zju.edu.cn
  • 作者简介:孙淼娟：女，本科，主管护师，E-mail：1712031@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技计划项目(2024KY1011);浙江省医药卫生科技计划项目(2024KY968);浙大一院护理科研项目(2022QF002);浙大一院护理科研项目(2024ZYHL07)

Early identification and perioperative nursing of pleuroperitoneal communication in patients with peritoneal dialysis complicated

SUN Miaojuan(), HE Peipei(), XIANG Shilong, HU Lijun   

  • Received:2024-10-23 Online:2025-09-10 Published:2025-09-02
  • Contact: HE Peipei E-mail:1712031@zju.edu.cn;1505044@zju.edu.cn

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摘要：

总结15例腹膜透析合并胸腹瘘行膈肌修补术患者的早期识别及围手术期护理经验。针对腹膜透析患者发生胸腹瘘易被忽视，术后护理不当易出现复发、肺不张等问题，采取术前胸腹瘘的精准分层管理与早期识别、多学科协作制订围手术期护理方案；术后实施小剂量渐进式递增透析方案、胸腔闭式引流与七步运动功能锻炼协同的肺康复等护理措施。经过精心治疗和护理，15例均康复出院，随访3~48个月，均未再次发生胸腹瘘，规律行腹膜透析治疗。

关键词: 腹膜透析, 胸腹瘘, 膈肌修补, 围手术期护理

Abstract:

To summarize the early identification and perioperative nursing experience of 15 patients with peritoneal dialysis complicated with pleuroperitoneal communication undergoing diaphragmatic repair. For peritoneal dialysis patients，the occurrence of pleuroperitoneal communication is easily overlooked，and improper postoperative nursing can lead to recurrence，atelectasis，and other issues. To address these issues，preoperative precise stratified management and early identification of pleuroperitoneal communication was taken，and perioperative nursing plan was developed by multidisciplinary cooperation. After operation，the nursing measures such as small dose progressive dialysis program，closed thoracic drainage and seven-step functional exercise coordinated lung rehabilitation were implemented. After careful treatment and nursing，15 patients recovered and were discharged. During the follow-up of 3 to 48 months，15 patients didn’t have pleuroperitoneal communication again，and they were treated with peritoneal dialysis regularly.

Key words: Peritoneal Dialysis, Pleuroperitoneal Communication, Diaphragmatic Repair, Perioperative Nursing