1例肾移植术后合并冠心病患者并发重症肺炎的护理实践
Nursing Practice of Severe Pneumonia in a Patient with Coronary Heart Disease after Renal Transplantation
摘要: 总结1例肾移植术后合并冠心病患者并发重症肺炎的护理经验，主要包括：俯卧位及俯卧位通气治疗，改善肺功能，注意皮肤及管路的维护，避免压力性损伤的发生；高热时及时给予降温措施，加强营养支持，减少并发症；抗凝及扩冠状动脉治疗，关注凝血功能，预防消化道出血；采用正念减压、倾听等负性情绪管理策略，改善患者焦虑及抑郁状态；做好患者的安全管理与指导，减少各种意外伤害的发生。经过28 d的诊疗与护理后，患者好转出院。
Abstract: Summarize the nursing practice of severe pneumonia in a patient with coronary heart disease after renal transplantation, mainly including: ventilation treatment in prone and prone position, im-proving lung function, paying attention to the maintenance of skin and pipeline, and avoiding stress injury; timely cooling measures during high fever, strengthening nutritional support, and educe complications; anticoagulation and coronary artery treatment, pay attention to coagulation function, prevent gastrointestinal bleeding; using negative emotional management strategies such as mind-fulness stress reduction and listening, to improve the anxiety and depression of patients; provide safety management and guidance for patients, and reduce the occurrence of various accidental in-juries. After 28 d of diagnosis and treatment and nursing, the patient was improved and discharged.
文章引用：魏玉玲, 贾云燕, 牟金金, 孔田甜, 孙家秀, 于亚南, 徐虹. 1例肾移植术后合并冠心病患者并发重症肺炎的护理实践[J]. 临床医学进展, 2023, 13(7): 11506-11511. https://doi.org/10.12677/ACM.2023.1371608

参考文献

[1] 地里亚尔•地里夏提, 凯赛尔江•卡地尔, 拜合提亚•阿扎提, 等. 肾移植术后新型冠状病毒感染受者院内死亡影响因素的系统评价与Meta分析[J]. 中华器官移植杂志, 2023, 44(1): 31-39.
[2] Cheng, X.S., Van Wagner, L.B., Costa, S.P., et al. (2022) Emerging Evidence on Coronary Heart Disease Screening in Kidney and Liver Transplantation Candidates: A Scientific Statement from the American Heart Association: Endorsed by the American Society of Trans-plantation. Circulation, 146, e299-e324. [Google Scholar] [CrossRef] 
[3] Jo, J., Crespo, G., Gregory, D., et al. (2023) Factors Associ-ated with Cardiovascular Events after Simultaneous Liver-Kidney Transplant from the US Multicenter Simultaneous Liv-er-Kidney Transplant Consortium. Hepatology Communications, 7, e2108. [Google Scholar] [CrossRef] [PubMed]
[4] 陈松, 张伟杰, 陈刚, 等. 器官移植受者2019新型冠状病毒感染临床诊疗工作指导意见(第一版) [J]. 中华器官移植杂志, 2020, 41(3): 136-139.
[5] Yang, X.B., Yu, Y., Xu, J.Q., et al. (2020) Clinical Course and Outcomes of Critically Ill Patients with SARS-CoV-2 Pneumonia in Wuhan, China: A Single-Centered, Retrospective, Observational Study. The Lancet Respiratory Medicine, 8, 475-481. [Google Scholar] [CrossRef] 
[6] Favà, A., Cucchiari, D., Montero, N., et al. (2020) Clinical Characteristics and Risk Factors for Severe COVID-19 in Hospi-talized Kidney Transplant Recipients: A Multicentric Cohort Study. American Journal of Transplantation, 20, 3030-3041. [Google Scholar] [CrossRef] [PubMed]
[7] Geetha, D., Kronbichler, A., Rutter, M., et al. (2022) Impact of the COVID-19 Pandemic on the Kidney Community: Lessons Learned and Future Directions. Nature Reviews Nephrology, 18, 724-737. [Google Scholar] [CrossRef] [PubMed]
[8] 马晓旭, 臧素华, 楚伟丽, 等. 肾移植术后新型冠状病毒肺炎二例诊疗体会[J]. 中华器官移植杂志, 2020, 41(4): 207-211.
[9] 胡瑞, 邱文龙, 赵喜红, 等. 从肾移植术后感染新冠肺炎谈免疫宿主低下人群的管理[J]. 中华危重病急救医学, 2022, 34(5): 492-496.
[10] 陈道南, 田锐, 王瑞兰. 清醒俯卧位通气和新型冠状病毒肺炎[J]. 中国中西医结合急救杂志, 2022, 29(1): 104-106.
[11] 汪晓语, 张伶俐, 成果. 营养支持在新型冠状病毒感染防治中的重要作用[J]. 四川大学学报(医学版), 2023, 54(1): 108-113.
[12] 北京高血压防治协会, 北京糖尿病防治协会, 北京慢性病防治与健康教育研究会, 等. 基层心血管病综合管理实践指南2020[J]. 中国医学前沿杂志(电子版), 2020, 12(8): 11-73.
[13] 黄倩, 陈松, 刘斌, 等. 肾移植受者继发新型冠状病毒感染免疫抑制方案的调整[J]. 临床外科杂志, 2021, 29(4): 385-387.
[14] 张纱纱, 王茜, 谢晓慧, 等. 55例肾移植术后感染新型冠状病毒患者的特点及治疗分析[J]. 中国药业, 2021, 30(17): 115-119.
[15] Maggiore, U., Abramowicz, D., Crespo, M., et al. (2020) How Should I Manage Immunosuppression in a Kidney Transplant Patient with COVID-19? An ERA-EDTA DESCARTES Expert Opinion. Nephrology Dialysis Transplantation, 35, 899-904. [Google Scholar] [CrossRef] [PubMed]
[16] 王静, 金璐. 正念减压疗法对老年冠心病合并心理障碍患者睡眠质量及主观幸福感的影响[J]. 护士进修杂志, 2019, 34(22): 2084-2087.
[17] 杨海鸿, 王静, 任月霞, 等. 正念减压疗法对冠心病合并高血压患者睡眠质量、心理状态及心血管事件发生率的影响[J]. 国际精神病学杂志, 2021, 48(2): 351-353, 358.
[18] 赵忠凤, 周雪. 正念减压护理模式对冠心病患者心理状态与睡眠质量的影响[J]. 现代中西医结合杂志, 2022, 31(13): 1877-1880.
[19] 徐彩红, 金爱莲, 谢美丽, 等. 个性化心理护理干预对老年冠心病患者心理状态和生活质量的影响[J]. 国际精神病学杂志, 2022, 49(5): 923-925, 929.
[20] 王彦傧, 耿妍, 赵永霞, 等. 心理护理干预对CCU首次住院患者心理状态、免疫功能及护理满意度的影响[J]. 齐鲁护理杂志, 2022, 28(13): 133-135.
[21] 左玉姣, 刘厂辉, 王春兰, 唐振旺. 针对性心理干预对行运动康复治疗的老年冠心病心衰患者负性情绪及心功能的影响[J]. 中国老年学杂志, 2016, 36(15): 3684-3685.
[22] 中国心血管疾病患者居家康复专家共识编写组. 中国心血管疾病患者居家康复专家共识[J]. 中国循环杂志, 2022, 37(2): 108-121.
[23] 陈麒麟, 李平, 郎月, 等. 新型冠状病毒肺炎相关肾脏损伤研究进展[J]. 肾脏病与透析肾移植杂志, 2020, 29(5): 458-463.
[24] 彭明, 李玉凯, 王岚, 等. 合并冠心病与否对新型冠状病毒肺炎患者疾病发展及预后的影响[J]. 天津医药, 2020, 48(7): 599-602.
[25] 张建伟, 吕韶钧, 马晶, 等. 新型冠状病毒肺炎流行期间居家冠心病患者不同运动干预与生活质量的关系研究[J]. 中国康复医学杂志, 2022, 37(2): 176-182.

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