总结1例特鲁索综合征引起的急性缺血性脑梗死合并肿瘤多发性脑转移伴出血患者的护理体会。针对患者病情突变、进展迅速,采取早期识别特鲁索综合征相关脑梗死,提高卒中和栓塞风险预警能力;加强脑出血风险预警及预防措施,提高猝死风险判断能力;监测与调节颅内压、血压稳定,避免加重脑梗死及脑出血;关注家属心理,实时做好沟通,提高家庭支持系统功能;基于个案管理模式的自我症状监测,重点预防脑出血等护理措施,患者得到早发现、早预警、早诊断、早治疗。住院第15天,病情稳定,顺利出院。随访2周,患者情况良好,无颅内出血情况。
To summarize the nursing experience of a patient with multiple acute ischemic cerebral infarction and hemorrhage caused by Trousseau syndrome and complicated with multiple tumor brain metastasis.In view of the mutation and rapid progress of the patient's condition,early identification of cerebral infarction related to Trousseau syndrome was adopted to improve the early warning ability of stroke and embolism risk. We strengthened the early warning and preventive measures of cerebral hemorrhage risk,and improved the ability to judge the risk of sudden death;monitored and regulated the stability of intracranial pressure and blood pressure to avoid aggravating cerebral infarction and cerebral hemorrhage;payed attention to the psychology of family members,communicated well and improve the function of family support system. We provided self-symptom monitoring based on case management mode,focused on nursing measures such as prevention of cerebral hemorrhage,enabled patients to get early detection,early warning,early diagnosis and early treatment. The patient was stable and discharge on the15th day of hospitali-zation. Two weeks of follow-up showed that the patient was in good condition without intracranial hemorrhage.
[1] 黎芳丽,姜卉,蒋锡丽.特鲁索综合征相关性急性脑梗死MRI表现[J].现代医用影像学,2020,29(5):843-846.
Li FL,Jiang H,Jiang XL.MRI manifestations of acute cerebral infarction associated withtrousseau syndrome[J ]. Mod Med Imageology,2020,29(5):843-846.
[2] 李佳佳,莫多,杨蓉,等. 反复发生的特鲁索综合征1例报告[J]. 中风与神经疾病杂志,2022,39(6):536-538.
Li JJ,Mo D,Yang R,et al.A case report of recurrent Truso syndrome[J]. J Apoplexy Nerv Dis,2022,39(6):536-538.
[3] 蔡春花,林少娜,林瑞云. 抗凝治疗下血栓持续进展的特鲁索综合征1例[J]. 汕头大学医学院学报,2020,33(1):49-51.
Cai CH,Lin SN,Lin RY.A case of Truso syndrome with continuous thrombosis progression under anticoagulant therapy[J]. J Shantou Univ Med Coll,2020,33(1):49-51.
[4] Zhen C,Wang YB,Wang HF,et al.Multiple cerebral infarction linked to underlying cancer:a review of Trousseau syndrome-related cerebral infarction[J]. Br J Hosp Med (Lond),2021, 82(5):1-7.
[5] Ling YT,Li YY,Zhang XY,et al.Clinical features of Trous-seau's syndrome with multiple acute ischemic strokes[J]. Neurol Sci,2022,43(4):2405-2411.
[6] 梁国华,赖宝瑜,彭慕立. 急性脑梗死出血转化的发生率及相关因素影响[J]. 中国医药指南,2020,18(14):36-37,40.
Liang GH,Lai BY,Peng ML.Incidence of hemorrhagic transformation in acute cerebral infarction and its related factors[J]. Guide China Med,2020,18(14):36-37,40.
[7] 陈国昌,石小峰,陆云涛. 老年急性大面积脑梗死患者持续颅内压监测联合阶梯式治疗的效果分析[J]. 中风与神经疾病杂志,2020,37(8):707-709.
Chen GC,Shi XF,Lu YT.Effect of continuous intracranial pressure monitoring combined with step-by-step therapy in elderly patients with acute massive cerebral infarction[J]. J Apo-plexy Nerv Dis,2020,37(8):707-709.
