To summarize the nursing experience of weaning in a ventilated patient with Lemierre syndrome and secondary glottis imperfection. In view of the difficulty of weaning and the high risk of re-intubation,we adopted respiratory support in acute phase,risk assessment before extubation and multi-disciplinary extubation strategy,post-extubation observation and emergency treatment,early warning assessment to balance bleeding and thrombosis,active infection control to prevent cross infection,staged rehabilitation training,goal-oriented nutritional support and positive psychological support and other measures. After 25 days of active treatment and nursing,the patient's condition improved,transferred to the rehabilitation hospital for continue treatment. The patients were followed up for 3 months and his life returned to normal.
ZHOU Feifei
,
GAO Chunhua
,
LIN Yan
. Nursing care of secondary glottis imperfection after weaning in a ventilated patient with Lemierre syndrome[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024
, 5(1)
: 47
-50
.
DOI: 10.3761/j.issn.2096-7446.2024.01.008
[1] Denis Spelman. Lemierre syndrome:Septic thrombophlebitis of the internal jugular vein[EB/OL]. (2023-03-06)[2023-03-29]. https://www.uptodate.cn/contents/zh-Hans/lemierre-syndrome-septic-thrombophlebitis-of-the-internal-jugular-vein?search=Lemierre&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#.
[2] 张悦悦,王田乔,邢小康,等. 坏死梭杆菌致Lemierre综合征一例[J]. 中华结核和呼吸杂志,2021,44(12):1106-1109.
Zhang YY,Wang TQ,Xing XK,et al.A case of Lemierre syndrome caused by Fusobacterium necrophorum[J]. Chin J Tuberc Respir Dis,2021,44(12):1106-1109.
[3] Rudd KE,Johnson SC,Agesa KM,et al.Global,regional,and national sepsis incidence and mortality,1990-2017:analysis for the Global Burden of Disease Study[J]. Lancet,2020,395(10219):200-211.
[4] 任宣霖,樊落,田金徽,等. ICU气管插管患者拔管指南的质量评价与内容分析[J]. 中华护理杂志,2022,57(8):1001-1007.
Ren XL,Fan L,Tian JH,et al.Quality evaluation and content analysis of guidelines of airway extubation for adult patients in ICU[J]. Chin J Nurs,2022,57(8):1001-1007.
[5] Henriques DP,Martins RHG,Cataneo AJM.Efficacy of injectable laryngoplasty with hyaluronic acid and/or calcium hydroxyapatite in the treatment of glottic incompetence. systematic review and meta-analysis[J]. J Voice,2023:S0892.
[6] 佘君,丁建文,申捷,等. 成人吸入性肺炎诊断和治疗专家建议[J]. 国际呼吸杂志,2022,42(2):86-96.
She J,Ding JW,Shen J,et al.Expert task force on diagnosis and treatment of aspiration pneumonia in adults[J]. Int J Respir,2022,42(2):86-96.
[7] Wen ZJ,Zhang HY,Ding JP,et al.Continuous versus intermittent subglottic secretion drainage to prevent ventilator-associated pneumonia:a systematic review[J]. Crit Care Nurse,2017,37(5):e10-e17.
[8] 高春华,俞超,王辉,等. 《俯卧位通气治疗核查单》的设计及在重度ARDS病人中的应用研究[J]. 护理研究,2021,35(24):4366-4371.
Gao CH,Yu C,Wang H,et al.Study on the design and application of prone positioning ventilation treatment checklist inpatients with severe ARDS[J]. Chin Nurs Res,2021,35(24):4366-4371.
[9] Joffe A,Barnes CR.Extubation of the potentially difficult airway in the intensive care unit[J]. Curr Opin Anaesthesiol,2022,35(2):122-129.
[10] Wilkinson JM,Codipilly DC,Wilfahrt RP.Dysphagia:evaluation and collaborative management[J]. Am Fam Physician,2021, 103(2):97-106.
[11] 李泳兴,马武华. 困难气管拔管的预测因素及拔管策略的研究进展[J]. 国际麻醉学与复苏杂志,2020,41(5):488-492.
Li YX,Ma WH.Predictive factors and extubation strategies in difficult tracheal extubation[J]. Int J Anesth Resus,2020,41(5):488-492.
[12] Estupiñán Artiles C,Regan JL,Donnellan C.Dysphagia screening in residential care settings:a scoping review[J]. Int J Nurs Stud,2021,114:103813.
