百草枯中毒患者长程体外膜肺氧合支持下行肺移植的术前护理

doi:10.3761/j.issn.2096-7446.2023.03.010

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (3): 245-248.doi: 10.3761/j.issn.2096-7446.2023.03.010

百草枯中毒患者长程体外膜肺氧合支持下行肺移植的术前护理

洪丽微, 侯春怡, 张会锦, 徐永昊, 黄小群, 叶桂连, 郑赛华, 林小玲

510120 广州市广州医科大学附属第一医院重症医学科（洪丽微,侯春怡,张会锦,徐永昊,黄小群,林小玲）,器官移植科（叶桂连）,胸外科（郑赛华）

收稿日期:2022-07-14 出版日期:2023-03-10 发布日期:2023-03-07
通讯作者: 侯春怡,E-mail：373769031@qq.com
作者简介:洪丽微：女,本科（硕士在读）,E-mail：1635185629@qq.com
基金资助:
广东省医学科学技术研究基金项目（A2022071）;广东省护士协会科研课题（gdshsxh2021a108）

Preoperative nursing for a case of paraquat poisoning patient undergoing lung transplantation under long-term ECMO support

HONG Liwei, HOU Chunyi, ZHANG Huijin, XU Yonghao, HUANG Xiaoqun, YE Guilian, ZHENG Saihua, LIN Xiaoling

Received:2022-07-14 Online:2023-03-10 Published:2023-03-07

摘要/Abstract

摘要： 报告1例百草枯中毒患者长程体外膜氧合（extracorporeal membrane oxygenation,ECMO）支持下肺移植的术前护理体会。针对患者百草枯中毒后出现急性呼吸窘迫综合征、多器官功能障碍综合征、呼吸衰竭等问题,采取组建ECMO多学科团队、连续性肾脏替代治疗、控制肺部感染、对症纠正多器官功能障碍综合症、ECMO并发症监测与护理、加强心理护理等多项针对性护理措施。经过35 d的ECMO治疗与精心护理,患者成功行肺移植手术,术后随访健康状况良好。

关键词: 百草枯, 中毒, 体外膜肺氧合, 肺移植, 手术前护理, 急症护理

Abstract: To report the preoperative nursing for a case of paraquat poisoning patient undergoing lung transplantation under long-term ECMO support. In terms of the patient's acute respiratory distress syndrome,multi-organ dysfunction syndrome and respiratory failure after paraquat poisoning,multiple targeted nursing measures were taken,including the formation of an ECMO multidisciplinary team,continuous renal replacement therapy,control of pulmonary infection,monitoring and nursing of ECMO complications,and strengthening psychological care. After 35 days of ECMO treatment,the patient successfully received lung transplantation and was good during postoperative follow-up.

Key words: Paraquat, Poisoning, Extracorporeal Membrane Oxygenation, Lung Transplantation, Preoperative Care, Emergency Nursing

洪丽微, 侯春怡, 张会锦, 徐永昊, 黄小群, 叶桂连, 郑赛华, 林小玲. 百草枯中毒患者长程体外膜肺氧合支持下行肺移植的术前护理[J]. 中华急危重症护理杂志, 2023, 4(3): 245-248.

HONG Liwei, HOU Chunyi, ZHANG Huijin, XU Yonghao, HUANG Xiaoqun, YE Guilian, ZHENG Saihua, LIN Xiaoling. Preoperative nursing for a case of paraquat poisoning patient undergoing lung transplantation under long-term ECMO support[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(3): 245-248.

参考文献

[1] 张波,桂莉,金静芬,等. 急危重症护理学[M]. 4版. 北京:人民卫生出版社,2018:197-199.
Zhang B,Gui L,Jin JF,et al.Emergency and critical care nursing[M]. Beijing:People's Medical Publishing House,2018:197-199.
[2] 段琬钰,樊卓,张文迪,等. 我国2008—2018年急性百草枯中毒患者的流行病学分析[J]. 河北医科大学学报,2022,43(1):80-83.
Duan WY,Fan Z,Zhang WD,et al.Epidemiological analysis of patients with acute paraquat poisoning in China from 2008—2018[J]. J Hebei Med Univ,2022,43(1):80-83.
[3] 张云,张晶,高霏,等. ECMO在农药中毒救治中的应用[J]. 中国急救复苏与灾害医学杂志,2020,15(12):1466-1470.
Zhang Y,Zhang J,Gao F,et al.The application of ECMO in the treatment of pesticide poisoning[J]. Chin J Emerg Resusc Disaster Med,2020,15(12):1466-1470.
[4] Li ZJ,Zhang DF,Zhang WH.Analysis of nosocomial infection and risk factors in patients with ECMO treatment[J]. Infect Drug Resist,2021,14:2403-2410.
[5] Extracorporeal Life Support Organization. ELSO guidelines for ECMO centers[EB/OL]. (2014-03)[2022-06-03]. https://www.elso.org/Portals/0/IGD/Archive/FileManager/faf3f6a3c7cusersshyerdocumentselsoguidelinesecmocentersv1.8.pdf.
[6] 中国医师协会体外生命支持专业委员会. 成人体外膜氧合循环辅助专家共识[J]. 中华重症医学电子杂志,2018,4(2):114-122.
Professional Committee of In Vitro Life Support of Chinese Medical Doctors Association. Expert consensus on supporting adult extracorporeal membrane oxygenation cycle[J]. Chin J Crit Care Intensive Care Med,2018,4(2):114-122.
[7] 侯春怡,曾兰芳,黄敬烨,等. 两种引血方法对连续性肾脏替代治疗患者血流动力学的影响[J]. 护士进修杂志,2014,29(17):1557-1559.
Hou CY,Zeng LF,Huang JY,et al.Study for the effect of hemodynamics for patients with continuous renal substitute by two kinds of two primers blood methods[J]. J Nurs Train,2014,29(17):1557-1559.
[8] 黄兆丹,周姓良,陈燕河,等. 双机换管法对连续性肾脏替代治疗患者上机血流动力学的影响[J]. 昆明医科大学学报,2018
39(9):65-68.
Huang ZD,Zhou XL,Chen YH,et al.Effect of dual tube replacement on the hemodynamics in patients undergoing continuous renal replacement therapy[J]. J Kunming Med Univ,2018,39(9):65-68.
[9] 王敏,李杰红,姚彩霞. 1例肺泡蛋白沉积症合并I型呼吸衰竭病人的循证护理[J]. 循证护理,2017,3(2):190-192.
Wang M,Li JH,Yao CX.Evidence-based nursing of a patient with pulmonary alveolar proteinosis(PAP）complicated with type I respiratory failure[J]. Chin Evid Based Nurs,2017,3(2):190-192.
[10] Lucchini A,de Felippis C,Pelucchi G,et al. Application of prone position in hypoxaemic patients supported by veno-venous ECMO[J]. Intensive Crit Care Nurs,2018,48:61-68.
[11] 李亮,孙兆瑞,任艺,等. 俯卧位通气治疗急性百草枯中毒致中重度急性呼吸窘迫综合征的临床研究[J]. 医学研究生学报,2019,32(1):69-72.
Li L,Sun ZR,Ren Y,et al.A clinical research of prone position ventilation in the treatment of moderate and severe ARDS caused by acute paraquat poisoning[J]. J Med Postgrad,2019,32(1):69-72.
[12] Roca O,Pacheco A,García-de-Acilu M. To prone or not to prone ARDS patients on ECMO[J]. Crit Care,2021,25(1):315.
[13] Dalton HJ,Reeder R,Garcia-Filion P,et al.Factors associated with bleeding and thrombosis in children receiving extracorporeal membrane oxygenation[J]. Am J Respir Crit Care Med,2017,196(6):762-771.
[14] 叶倩倩,石磊,黄勋,等. 某三甲医院ECMO相关医院感染的危险因素研究[J]. 中国感染控制杂志,2021,20(5):415-421.
Ye QQ,Shi L,Huang X,et al.Risk factors for healthcare-associated infection in patients with extracorporeal membrane oxygenation in a tertiary hospital in China[J]. Chin J Infect Control,2021,20(5):415-421.

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百草枯中毒患者长程体外膜肺氧合支持下行肺移植的术前护理

Preoperative nursing for a case of paraquat poisoning patient undergoing lung transplantation under long-term ECMO support

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