首页|一例重症急性胰腺炎并发重型Stevens-Johnson综合征/中毒性表皮坏死松解症患者的感染防控

一例重症急性胰腺炎并发重型Stevens-Johnson综合征/中毒性表皮坏死松解症患者的感染防控

One case:Infection control in a patient with severe acute pancreatitis complicated with severe Stevens-Johnson syndrome/toxic epidermal necrolysis

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目的 总结1例重症急性胰腺炎(SAP)患者治疗期间并发重型Stevens-Johnson综合征(SJS)/中毒性表皮坏死松解症(TEN)的感染防控经验和体会.方法 我院于2021年3月12日收治1例SJS/TEN患者.护理要点:包含从疾病本身出发识别感染源、采取有针对性措施控制感染源、集束化方案切断传播途径、提高自身免疫力以保护感染人群4方面.其中重点针对患者皮肤损伤在同一时段的不同表现,采取分阶段的皮肤护理策略;充分补液,准确控制出入量,早期进行营养支持;及时予心理护理及适时的镇痛措施,缓解焦虑情绪.结果 患者于入院后103 d痊愈顺利出院.结论 股骨近端防旋髓内钉内固定手术中应用仰卧"剪刀"体位并结合护理人员针对性的术前情绪管理、深呼吸训练、咳嗽训练、卧床排便,术中体位摆放,术后功能锻炼可缩短患者手术时间,减少术中出血量及术中透视次数,降低并发症发生率,值得临床推广.
Objective To summarize the infection prevention and control experience of a patient with severe acute pancreatitis(SAP)complicated with severe Stevens-Johnson syndrome(SJS)/toxic epidermal necrolysis during treat-ment(TEN).Methods On March 12,2021,our hospital admitted one SJS/TEN patient.The key nursing points fo-cused on 4 aspects to protect the infected population,which were to identify the source of infection from the disease itself,take targeted measures to control the source of infection,cut off the route of transmission,and improve their own immunity.It focused on the different manifestations of skin injury in the same period of time,a phased skin care strategy was adopted;Adequate fluid replenishment,accurate control of the amount in and out,and early nutritional support;Timely psychological care and timely analgesic measures to relieve anxiety.Results The patient recovered 103 days after admission and was discharged successfully.Conclusion The patient in this case has double severe infec-tion with multiple serious complications and a high mortality rate.Through systematic treatment and nursing,the risk of infection and complications during the treatment process has been reduced,and the patient's recovery process has been accelerated.

severe acute pancreatitistoxic epidermal necrolysisinfectionnursing

李艳丽、王硕、王欣然

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首都医科大学宣武医院普外ICU,北京 100053

首都医科大学宣武医院普外科,北京 100053

重症急性胰腺炎 中毒性表皮坏死松解症 感染 护理

2024

护士进修杂志
贵州省医药卫生学会办公室

护士进修杂志

CSTPCD
影响因子:2.59
ISSN:1002-6975
年,卷(期):2024.39(3)
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