总结1例疥疮感染患者行冠状动脉旁路移植术的围手术期护理体会。针对患者疥疮传染期行手术治疗,医护人员防护经验欠缺、重症患者普遍易感、感染防控难度大等问题,采取组建多学科防控组及护理专项组,提升疥疮防控能力;严格把控疥疮传染三大环节,预防院内感染发生;做好疥疮用药及皮肤管理等措施。经过17 d积极治疗与精心护理,患者症状及体征改善,局部刮片虫卵检测阴性,未发生院内感染,隔离解除后转普通病房继续治疗,术后第28天顺利出院。
To summarize the perioperative nursing experience of coronary artery bypass grafting in a patient with scabies infection. In view of the problems of surgical treatment in the infection period of scabies infection,lack of protection experience of medical staff,common susceptibility of the severe patient,and difficulty of infection prevention and control,a multidisciplinary prevention and control team and a special nursing team were established to improve the ability of scabies prevention and control. We strictly controlled the three links of scabies infection to prevent the occurrence of nosocomial infection,took good measures of scabies medication and skin management. After 17 days of active treatment and careful care,the patient‘s symptoms and signs improved,local spatula eggs were negative,and no nosocomial infection occurred. After the isolation was released,the patient was transferred to the general ward for further treatment,and was discharged successfully on the 28th day after surgery.
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