总结1例因长期饮酒致硫胺素缺乏引起湿性脚气病伴多器官功能损害患者的护理体会。针对患者临床表现不典型、易骤发难治性休克及多器官功能衰竭等特点，采取多维度评估策略，快速精准识别湿性脚气病；制订维生素B1降阶梯治疗路径，确保安全有效补充硫胺素；实施精准化容量管理，纠正充血性心力衰竭；落实个体化通气与康复策略，促进肺功能恢复；早期启动肾脏替代治疗，纠正酸中毒、改善肾损伤；应用二元应对理论联合信息-动机-行为技巧模型，实施健康教育。经精心救护，患者住院第7天后顺利转至普通病房，第13天顺利出院。随访3个月，患者恢复良好。

To summarized the nursing experience of a patient with wet beriberi and multiple organ dysfunction caused by thiamine deficiency due to chronic alcoholism. For the patient with atypical clinical manifestations，sudden onset of refractory shock，and multi-organ failure，a multidimensional assessment strategy was adopted to rapidly and accurately identify wet beriberi. A step-down vitamin B1 protocol was formulated to ensure safe supplementation of thiamine. Precision volume management was implemented to correct congestive heart failure，individualized ventilation and rehabilitation strategy was applied to promote lung pulmonary recovery. Renal replacement therapy was early initiated to correct acidosis and improve renal injury. Health education was guided by dyadic coping theory and information-motivation-behavioral model. Through timely treatment and meticulous care，the patient was transferred to a general ward after 7 days，discharged on day 13，and showed good recovery at 3-month follow-up.