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
临床实践

急性坏死性筋膜炎伴感染性休克患者行负压创面治疗的护理

  • 曾颖 ,
  • 王薇 ,
  • 黄旭叶 ,
  • 陈文斌
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  • 310003 杭州市 浙江大学医学院附属第一医院结直肠外科(曾颖,黄旭叶,陈文斌),护理部(王薇)
曾颖:女,本科(硕士在读),主管护师,E-mail:1709033@zju.edu.cn

收稿日期: 2021-07-28

  网络出版日期: 2022-01-17

基金资助

浙江省医药卫生科技项目(2020370525,2020377755);浙江省基础公益研究计划项目(LGF18H030001)

Nursing care of negative pressure wound treatment for a patient with acute necrotizing fasciitis with septic shock

  • ZENG Ying ,
  • WANG Wei ,
  • HUANG Xuye ,
  • CHEN Wenbin
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Received date: 2021-07-28

  Online published: 2022-01-17

摘要

总结1例大面积急性坏死性筋膜炎合并造口皮肤黏膜分离伴感染性休克患者行负压创面治疗(negative pressure wound therapy,NPWT)的护理体会。由医生、护士、造口治疗师、营养师共同参与制订伤口管理方案,综合评估患者情况后,采用改良可持续冲洗负压创面治疗技术、造口粪水管理、带毛囊游离皮肤移植术后伤口护理及全程营养管理。86 d后患者康复出院。

本文引用格式

曾颖 , 王薇 , 黄旭叶 , 陈文斌 . 急性坏死性筋膜炎伴感染性休克患者行负压创面治疗的护理[J]. 中华急危重症护理杂志, 2022 , 3(1) : 86 -88 . DOI: 10.3761/j.issn.2096-7446.2022.01.016

Abstract

To summarize the nursing care of negative pressure wound therapy(NPWT) for a case of massive acute necrotizing fasciitis with septic shock and mucocutaneous separation of the stoma. Wound management involved doctors,nurses,stoma therapists,and dietitians jointly to formulate the plan. After comprehensive assessment of the patient's condition,a special care plan was adopted for removing the cause of infection,including modified and sustainable NPWT wound treatment care,stoma feces management,wound care after free skin transplantation with hair follicles and whole-process nutritional management. The patient recovered and was discharged 86 days later.

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