1例直肠癌术后合并糖尿病患者肛周坏死性筋膜炎手术护理配合

Operative Nursing Cooperation for Perianal Necrotizing Fasciitis in 1 Patient with Postoperative Rectal Cancer Complicated with Diabetes Mellitus

摘要: 总结1例直肠癌术后、2型糖尿病合并肛周及左侧臀部坏死性筋膜炎患者行左臀部切开扩创减压 + 皮瓣修整 + 血管神经探查 + 横结肠造口术的手术室护理经验。护理要点包括强化术前访视与心理干预、制定个性化术中护理方案、组建多学科协作团队、实施指标化术中血流调整、落实科学化全程体温防护、严格术中感染防控及精准预防术中压力性损伤。经精细化术前准备与术中护理配合，患者手术过程平稳，术后创面恢复良好，顺利转出专科病房，为同类基础病合并重症坏死性筋膜炎患者的手术室护理提供实践参考。

Abstract: This paper summarizes the operating room nursing experience of one patient with perianal and left gluteal necrotizing fasciitis after rectal cancer surgery combined with type 2 diabetes mellitus, who underwent left gluteal incision, debridement and decompression, flap revision, vascular and nerve exploration, and transverse colostomy. The key nursing points include enhanced preoperative visit and psychological intervention, formulation of personalized intraoperative nursing plan, establishment of a multidisciplinary team, implementation of indexed intraoperative hemodynamic adjustment, scientific whole-course body temperature protection, strict intraoperative infection prevention and control, and precise prevention of intraoperative pressure injury. Through refined preoperative preparation and intraoperative nursing cooperation, the patient had a stable operation process, good postoperative wound recovery, and was successfully transferred to a specialized ward. It provides practical reference for operating room nursing of patients with severe necrotizing fasciitis complicated with similar underlying diseases.