总结1例前纵隔淋巴瘤并发严重气道梗阻及上腔静脉压迫患儿的抢救和护理体会。护理要点：做好纵隔淋巴瘤局部压迫导致呼吸困难的早期识别,有效应用体外膜肺氧合干预;在体外膜肺氧合串联连续性血液净化运行期间密切观察病情,动态评估气道梗阻症状,持续监测上腔静脉压迫情况;及时观察并有效处理低血压、出血等并发症以及高血钾、低血钙等肿瘤溶解综合征。经过精心的治疗和护理,体外膜氧合运行12 d后成功撤离,患儿于入科第20天病情恢复平稳,转至血液科继续进行专科治疗。
This paper summarized the rescue and the nursing care of a case of anterior mediastinal lymphoma complicated with severe airway obstruction and superior vena cava compression. Key nursing pointes included early identification of dyspnea caused by local compression of mediastinal lymphoma,effective intervention of extracorporeal membrane oxygenation. During the operation of extracorporeal membrane oxygenation combined with continuous blood purification,the patient was closely observed,symptoms of airway obstruction were dynamically evaluated,and pressure of superior vena cava was continuously monitored. We timely observed and effectively treated hypotension,bleeding and other complications,tumor lysis syndrome such as hyperkalemia and hypocalcemia. After careful treatment and nursing,the extracorporeal membrane lung machine was successfully evacuated after 12 days of operation. The patient's condition recovered steadily on the 20th day of admission and was transferred to hematology department for further specialized treatment.
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