体外膜肺氧合联合连续性肾脏替代治疗患者的护理

doi:10.3761/j.issn.2096-7446.2022.01.017

中华急危重症护理杂志 ›› 2022, Vol. 3 ›› Issue (1): 89-91.doi: 10.3761/j.issn.2096-7446.2022.01.017

体外膜肺氧合联合连续性肾脏替代治疗患者的护理

贾雪萍, 曾磊, 杨红晓, 李桂芳

750000 银川市宁夏医科大学护理学院（贾雪萍）; 宁夏医科大学总医院重症医学科（曾磊,杨红晓,李桂芳）

收稿日期:2021-07-06 出版日期:2022-01-10 发布日期:2022-01-17
通讯作者: 李桂芳,E-mail：lgf3446@163.com
作者简介:贾雪萍：女,本科（硕士在读）,护士,E-mail：1305366414@qq.com

Nursing care of a patient treated by extracorporeal membrane oxygenation combined with continuous renal replacement therapy

JIA Xueping, ZENG Lei, YANG Hongxiao, LI Guifang

Received:2021-07-06 Online:2022-01-10 Published:2022-01-17

摘要/Abstract

摘要： 总结1例多发伤并发多器官功能障碍综合征行体外膜肺氧合联合连续性肾脏替代治疗患者的护理体会。针对该患者体外膜肺氧合管路固定、凝血监测、血流动力学紊乱等安全问题,给予胸腔闭式引流联合机械通气护理及压力性损伤的预防,并对常规护理措施进行调整;根据患者意识、ICU活动评分给予以护士为主导的早期分级康复活动方案,其中肢体功能锻炼、主动活动和被动活动结合、保证活动安全是护理难点也是关键点。经过26 d治疗及护理,患者好转出院。出院后随访2个月,状况良好。

关键词: 多器官功能障碍综合征, 体外膜肺氧合, 连续性肾脏替代疗法, 急症护理

Abstract: To summarize the nursing experience of a patient with multiple injury complicated with multiple organ dysfunction syndrome who underwent extracorporeal membrane oxygenation combined with continuous renal replacement therapy. Conventional nursing measures were adjusted for safety problems such as pipeline fixation of extracorporeal membrane lung oxygenation,coagulation monitoring,hemodynamic disorders. Thoracic closed drainage combined with mechanical ventilation nursing and pressure injury prevention were given. According to patients' consciousness and ICU activity score,early graded rehabilitation activity program led by nurses was given,among which physical function exercise,combination of active and passive activities,and activity safety were the difficulties and key points of nursing. After 26 days of treatment and nursing,the patient's condition was improved and he was discharged. He was in good condition after 2 months of follow-up.

Key words: Multiple Organ Dysfunction Syndrome, Extracorporeal Membrane Oxygenation, Continuous Renal Replacement Therapy, Emergency Nursing

贾雪萍, 曾磊, 杨红晓, 李桂芳. 体外膜肺氧合联合连续性肾脏替代治疗患者的护理[J]. 中华急危重症护理杂志, 2022, 3(1): 89-91.

JIA Xueping, ZENG Lei, YANG Hongxiao, LI Guifang. Nursing care of a patient treated by extracorporeal membrane oxygenation combined with continuous renal replacement therapy[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(1): 89-91.

参考文献

[1] 张凡,张静萍. ICU多发伤患者护理监测评估量表的构建及信效度检验[J]. 中华现代护理杂志,2020,26(16):2157-2162.
Zhang F,Zhang JP.Construction of ICU nursing monitoring and evaluation scale for patients with multiple trauma and its reliability and validity test[J]. Chin J Mod Nurs,2020,26(16):2157-2162.
[2] 陈丽花,谢派玲,曾丽婷,等. 体外膜肺氧合联合连续性肾脏替代治疗的连接方式及护理[J]. 护理研究,2020,34(18):3355-3358.
Chen LH,Xie PL,Zeng LT,et al.Connection methods and nursing care of extracorporeal membrane oxygenation combined with continuous renal replacement therapy[J]. Chin Nurs Res,2020,34(18):3355-3358.
[3] 石秀茹,郭远,郑凯兰,等. 1例危重型新型冠状病毒肺炎患者并发消化道出血应用体外膜肺氧合治疗的护理[J]. 中华护理杂志,2020,55(S1):675-677.
Shi XR,Guo Y,Zheng KL,et al.Nursing of a critical COVID-19 patient complicated with gastrointestinal bleeding treated with extracorporeal membrane oxygenation[J]. Chin J Nurs,2020,55(S1):675-677.
[4] 李云. V-A ECMO联合CRRT治疗急性爆发性心肌炎合并多脏器功能衰竭患者的护理[J]. 齐鲁护理杂志,2020,26(7):118-120.
Li Y.Nursing care of patients with acute explosive myocarditis complicated with multiple organ failure treated by V-A ECMO combined with CRRT[J]. J Qilu Nurs,2020,26(7):118-120.
[5] 左文青,张卫,林芳,等. 体外膜肺氧合联合连续性肾脏替代治疗患者局部行枸橼酸抗凝的护理[J]. 中华急危重症护理杂志,2020,1(3):238-240.
Zuo WQ,Zhang W,Lin F,et al.The nursing care of regional citrate anticoagulation in patients treated with extracorporeal membrane oxygenation combined with continuous renal replacement therapy[J]. Chin J Emerg Crit Care Nurs,2020,1(3):238-240.
[6] 胡燕. 目标导向早期康复对机械通气患者ICU获得性衰弱影响的研究[D]. 南昌:南昌大学,2020.
Hu Y.Effect of early goal directed mobilization on ICU acquired weakness in ICU patients with mechanical ventilation[D]. Nanchang:Nanchang University,2020.
[7] 张川林,张泽菊,米洁,等. ICU活动量表的汉化及信效度研究[J]. 护理学杂志,2019,34(10):46-48.
Zhang CL,Zhang ZJ,Mi J,et al.Translation of the ICU mobility scale into Chinese and validation[J]. J Nurs Sci,2019,34(10):46-48.
[8] 徐小兰,鲁亚平. 护理学基础[M]. 3版. 北京:高等教育出版社,2015.
Xu XL,Lu YP.Fundamental nursing[M]. 3rd ed. Beijing:Higher Education Press,2015.
[9] 王钰炜,周帅帅,林高兴,等. 创伤性心搏骤停患者应用体外膜肺氧合治疗的急救护理[J]. 中华急危重症护理杂志,2021,2(1):87-90.
Wang YW,Zhou SS,Lin GX,et al.Emergency care of a patient with traumatic cardiac arrest by extracorporeal membrane oxygenation[J]. Chin J Emerg Crit Care Nurs,2021,2(1):87-90.

[1]	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.
[2]	赵丽华, 郑一梅, 袁翠, 张建霞, 叶晶. ICU护士体外膜肺氧合护理核心能力的现状及影响因素分析[J]. 中华急危重症护理杂志, 2026, 7(5): 595-601.
[3]	张添羽, 程玲灵, 程臻, 邵微颖, 石爱丽. 早期活动对成人体外膜肺氧合患者临床结局影响的Meta分析[J]. 中华急危重症护理杂志, 2026, 7(5): 616-622.
[4]	李传圣, 米元元, 陈丽花, 黄维健. 体外膜肺氧合护士应急能力评价指标体系的构建及适用性分析[J]. 中华急危重症护理杂志, 2026, 7(4): 425-431.
[5]	马娜, 陈旭锋, 陈凤, 张阳春, 季学丽. 体外膜肺氧合护士护理体验质性研究的Meta整合[J]. 中华急危重症护理杂志, 2026, 7(4): 440-446.
[6]	丁幼芽, 王飒, 闫丹萍, 周帅帅, 武作家, 王钰炜. 甲醇中毒致顽固性低钾血症患者的护理[J]. 中华急危重症护理杂志, 2026, 7(4): 447-449.
[7]	张帅, 高昕, 钱佳微, 王晓, 沈丹萍, 李文雅, 沈秀兰. 体外膜肺氧合患者氧合器全流程管理方案的构建及可行性分析[J]. 中华急危重症护理杂志, 2026, 7(3): 266-273.
[8]	陈兆斐, 王薇, 翟振国. 静脉血栓栓塞症一体化防治策略的实施与质量控制[J]. 中华急危重症护理杂志, 2026, 7(3): 274-278.
[9]	于雅诺, 宋雨航, 高凌婕, 李晓波. 临床决策支持系统在急诊分诊管理中应用的范围综述[J]. 中华急危重症护理杂志, 2026, 7(3): 306-311.
[10]	高彬炳, 王飒, 周帅帅, 张玉坤, 王钰炜. 肺栓塞致心搏骤停患者并发肝血管瘤破裂的急救护理[J]. 中华急危重症护理杂志, 2026, 7(3): 315-318.
[11]	徐雅玲, 袁静, 张玉姣, 王微娜, 应金萍. 老年肺移植并发横纹肌溶解患者行连续性肾脏替代治疗的护理[J]. 中华急危重症护理杂志, 2026, 7(3): 322-324.
[12]	马建萍, 黄培, 林瑶, 夏柳勤, 张茜, 郑越, 杨湘英. 可视化导航式体外膜肺氧合预充装置的设计及在ICU护士培训中的应用[J]. 中华急危重症护理杂志, 2026, 7(2): 248-252.
[13]	夏致远, 何佳, 王黎醒, 石义容, 杨敏, 王荀, 黄燕梅, 李志艳, 张利. 钩吻群体中毒患者跨机构协作及急救护理[J]. 中华急危重症护理杂志, 2026, 7(1): 77-79.
[14]	刘宇亭, 祁梦莹, 蒙斯雅, 王冰寒, 王乔莎, 何桂兰. 成人体外膜肺氧合镇痛镇静管理方案的构建及应用效果研究[J]. 中华急危重症护理杂志, 2025, 6(8): 901-907.
[15]	杨晓华, 孙婷, 王萍, 姚梅琪. 1例高龄患者因水摄入过量致重度低钠血症的急救与警示[J]. 中华急危重症护理杂志, 2025, 6(8): 995-997.

体外膜肺氧合联合连续性肾脏替代治疗患者的护理

Nursing care of a patient treated by extracorporeal membrane oxygenation combined with continuous renal replacement therapy

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价