总结1例肝癌晚期患者因胰岛素样生长因子-2过度分泌致反复低血糖的护理体会。针对患者频发重度低血糖,化疗后并发口腔炎及胃肠道反应,患病过程中情绪波动大等棘手问题,护理要点：多学科协作寻找低血糖原因及制订治疗方案;24 h持续动态监测血糖寻找低血糖规律并制订低血糖防治方案;维持营养支持与低血糖控制的平衡;应用非暴力沟通与患者建立信任,帮助患者正性应对疾病;信息化出院宣教及随访,避免出院后低血糖昏迷的发生。经积极治疗与护理,患者未再次出现低血糖昏迷,血糖得到控制,口腔炎治愈,营养摄入好转,心态得到调整,病情稳定后出院。
This article summarized the nursing experience of a patient who has advanced liver cancer with repeated hypoglycemia due to excessive secretion of insulin-like growth factor-2（IGF-2）. For patient with frequent severe hypoglycemia,stomatitis and gastrointestinal reaction after chemotherapy,emotion fluctuation during the illness and other problems,key nursing points included multi-disciplinary collaboration to find the causes of hypoglycemia and develop prevention and treatment plan to reduce the risk of hypoglycemia,continuous dynamic monitoring of blood glucose for 24 hours to identify hypoglycemia rules,maintaining the balance between nutrient intake and hypoglycemia,establishment of trust by non-violent communication with patients to help the patient positively cope with the disease informatized discharge education and follow-up to avoid hypoglycemic coma after discharge. After active treatment and nursing,the patient did not develop a hypoglycemic coma again,blood glucose was controlled,stomatitis was cured,nutrition intake improved,mentality was adjusted. The patient was discharged after stable condition.
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