护理主导MDT模式下石骨症合并双侧视力障碍的多重高危孕产妇围产期护理

Perinatal Nursing of a High‑Risk Pregnant Woman with Osteopetrosis and Bilateral Visual Impairment under the Nursing‑Led MDT Model

摘要: 目的：构建护理主导MDT模式下石骨症合并双侧视力障碍、瘢痕子宫的多重高危孕产妇围产期精准护理框架，为同类罕见病例提供参考思路。方法：针对1例石骨症合并多重高危因素的孕产妇，组建以护理为核心的MDT团队，基于“风险分层–精准干预–感官代偿–中西医融合”四维框架，实施高危因素全程预警、骨脆性适配活动管理、三维感官代偿体系构建、容量–贫血协同管理等个体化护理措施。结果：患者术后3天血红蛋白升至107 g/L，VAS疼痛评分维持1~2分，未发生骨折、血栓、感染等并发症，母婴于术后第5天康复出院；产后2个月随访，母婴健康状况良好。结论：护理主导MDT模式下构建的四维精准护理框架，为石骨症合并多重高危妊娠孕产妇照护提供一个有潜力的实践方案，其有效性有待更高证据等级的研究加以验证。

Abstract: Objective: To construct a precise perinatal nursing framework for high-risk pregnant women with osteopetrosis, bilateral visual impairment, and a scarred uterus under the nursing-led Multidisciplinary Team (MDT) model, and to provide reference ideas for the care of similar rare cases. Methods: For one pregnant woman with osteopetrosis and multiple high-risk factors, an MDT team centered on nursing was established. Based on the four-dimensional framework of “risk stratification-precise intervention-sensory compensation-integration of traditional Chinese and Western medicine”, individualized nursing measures were implemented, including whole-process early warning of high-risk factors, bone fragility-adapted activity management, construction of a three-dimensional sensory compensation system, and coordinated management of fluid volume and anemia. Results: On the 3rd postoperative day, the patient’s hemoglobin increased to 107 g/L, and the Visual Analog Scale (VAS) pain score was maintained at 1~2 points. No complications such as fractures, thrombosis, or infections occurred, and both the mother and the baby were discharged from the hospital on the 5th postoperative day after recovery. A follow-up 2 months after delivery showed that both the mother and the baby were in good health. Conclusion: The four-dimensional precision nursing framework constructed under the nursing-led MDT model may provide a potential practical scheme for the perinatal care of pregnant women with osteopetrosis and multiple high-risk factors, though its effectiveness requires further validation through higher-level evidence studies.