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
重症护理研究

致命性肺血栓栓塞症患者高出血风险下行体外膜肺氧合的护理

  • 李旭琴 ,
  • 黄昉芳 ,
  • 俞超
展开
  • 310006 杭州市 浙江大学医学院附属第一医院护理部
李旭琴:女,本科,主管护师,E-mail:843097724@qq.com
黄昉芳,E-mail:huangfangfang517@zju.edu.cn

收稿日期: 2024-06-05

  网络出版日期: 2025-04-08

Nursing care of a patient with fatal pulmonary thromboembolism undergoing extracorporeal membrane oxygenation under high bleeding risk

  • LI Xuqin ,
  • HUANG Fangfang ,
  • YU Chao
Expand

Received date: 2024-06-05

  Online published: 2025-04-08

摘要

总结1例致命性肺血栓栓塞症患者高出血风险下行体外膜肺氧合的护理。护理要点:高出血风险期间体外膜肺氧合运行的出血风险管理。低抗凝期间的观察与护理包括个体化低抗凝方案的实施与护理、小血栓引起体外膜肺引流不足的应急护理策略、高凝状态下保持下肢远端灌注管通畅,避免下肢缺血。以及在体外膜肺支持下经皮肺动脉取栓术后观察与护理。经过积极抢救,精心治疗与护理,患者好转出院,随访期间,患者恢复良好。

本文引用格式

李旭琴 , 黄昉芳 , 俞超 . 致命性肺血栓栓塞症患者高出血风险下行体外膜肺氧合的护理[J]. 中华急危重症护理杂志, 2025 , 6(4) : 462 -465 . DOI: 10.3761/j.issn.2096-7446.2025.04.014

Abstract

To summarize the nursing care of a patient with fatal pulmonary thromboembolism undergoing extracorporeal membrane oxygenation under high bleeding risk. Key points of care included bleeding risk management during extracorporeal membrane oxygenation in periods of high bleeding risk. Observation and nursing during the period of low anticoagulation included the implementation and nursing of individualized low anticoagulation program,emergency nursing strategy for insufficient extracorporeal membrane drainage caused by small thrombus,and keeping the distal perfusion tube of lower limb open in the state of high coagulation to avoid lower limb ischemia. And the observation and nursing after percutaneous pulmonary embolectomy with extracorporeal membrane lung support was implemented. After active rescue,careful treatment and nursing,the patient improved and was discharged from the hospital. During the follow-up,the patient recovered well.

参考文献

[1] 高春华, 俞超, 王辉, 等. 焦虑合并躯体形式障碍患者突发急性肺栓塞的急救护理[J]. 中华急危重症护理杂志, 2021, 2(2):171-174.
  Gao CH, Yu C, Wang H, et al. Emergency nursing for acute pulmonary embolism in patient with anxiety complicated with somatoform disorder[J]. Chin J Emerg Crit Care Nurs, 2021, 2(2):171-174.
[2] 中国静脉介入联盟, 中国医师协会介入医师分会外周血管介入专业委员会, 国际血管联盟中国分部护理专业委员会. 致命性肺血栓栓塞症急救护理专家共识[J]. 中华现代护理杂志, 2023, 29(17):2241-2250.
  Chinese Veins Interventional Alliance, Peripheral Vascular Intervention Professional Committee of the Interventional Physician Branch of the Chinese Medical Doctor Association, Nursing Professional Committee of China Branch of International Angio-logy Union. Expert consensus on emergency nursing for fatal pulmonary thromboembolism[J]. Chin J Mod Nurs, 2023, 29(17):2241-2250.
[3] Boey JJE, Dhundi U, Ling RR, et al. Extracorporeal membrane oxygenation for pulmonary embolism:a systematic review and meta-analysis[J]. J Clin Med, 2023, 13(1):64.
[4] 宣烨菁, 梁江淑渊, 曾妃. 高处坠落致截瘫患者术后急性肺栓塞体外膜肺氧合下取栓的护理[J]. 中华急危重症护理杂志, 2024, 5(6):541-544.
  Xuan YJ, Liang JSY, Zeng F, et al. Nursing care of thrombus removal under extracorporeal membrane oxygenation in a patient with postoperative acute pulmonary embolism after paraplegia caused by fall from height[J]. Chin J Emerg Crit Care Nurs, 2024, 5(6):541-544.
[5] 李旭琴, 冯洁惠, 黄昉芳, 等. 1例行机械循环辅助桥接心脏移植患者的术前护理[J]. 中华护理杂志, 2024, 59(9):1114-1118.
  Li XQ, Feng JH, Huang FF, et al. Nursing care of a patient with acute myocardial infarction complicated with cardiogenic shock before operation with mechanical circulation-assisted bridging heart transplantation[J]. Chin J Nurs, 2024, 59(9):1114-1118.
[6] Vandenbriele C, Mueller T, Patel B. Consumptive coagulopathy:how low-dose unfractionated heparin can prevent bleeding complications during extracorporeal life support[J]. Intensive Care Med, 2024, 50(8):1358-1360.
[7] 白伟民, 秦历杰, 杨晓哲, 等. 低血流时间对体外膜肺氧合辅助心肺复苏患者预后的影响[J]. 中国心血管杂志, 2023, 28(3):246-250.
  Bai WM, Qin LJ, Yang XZ, et al. Effect of low blood flow time on prognosis in patients with cardiopulmonary resuscitation assisted by extracorporeal membrane oxygenation[J]. Chin J Car-diovasc Med, 2023, 28(3):246-250.
[8] 中国医师协会体外生命支持专业委员会, 山东省医师协会体外生命支持专业委员会. 中国成人经股动脉VA-ECMO治疗期间下肢缺血防治专家共识(2023)[J]. 中华危重病急救医学, 2023, 35(8):785-792.
  Extracorporeal Life Support Professional Committee of Chinese Medical Doctor Association, Extracorporeal Life Support Pro-fessional Committee of Shandong Physician Association. Expert consensus on prevention and treatment of lower limb ischemia during transfemoral veno-arterial extracorporeal membrane oxygenation therapy in adults in China(2023)[J]. Chin Crit Care Med, 2023, 35(8):785-792.
[9] 中华医学会心血管病学分会, 中国医师协会心血管内科医师分会肺血管疾病学组, 中国肺栓塞救治团队(pert)联盟. 急性肺栓塞多学科团队救治中国专家共识[J]. 中华心血管病杂志, 2022, 50(1):25-35.
  Cardiology Branch of Chinese Medical Association, Pulmonary Vascular Diseases Group of Cardiovascular Physician Branch of Chinese Medical Doctor Association, China Consortium of Pulmonary Embolism Response Team. Chinese expert consensus on the treatment of acute pulmonary embolism by the multidisciplinary team[J]. Chin J Cardiol, 2022, 50(1):25-35.
文章导航

/