1例左室心肌致密化不全并发暴发性心肌炎患者行体外膜肺氧合的护理
Nursing Care of a Patient with Left Ventricular Noncompaction Complicated by Fulminant Myocarditis Undergoing Extracorporeal Membrane Oxygenation
DOI: 10.12677/acm.2024.1492537, PDF,   
作者: 李瓶芝*, 尹礼义：湖南省人民医院(湖南师范大学附属第一医院)急诊医学科，湖南 长沙
关键词: 左室心肌致密化不全；暴发性心肌炎；机械循环辅助；护理；Left Ventricular Noncompaction； Fulminant Myocarditis； Mechanical Cycle Assisted； Nursing Care
摘要: 总结1例左室心肌致密化不全并发暴发性心肌炎患者行体外膜肺氧合的护理。护理要点如下：机械循环辅助期间动态监测患者生命体征变化；加强管道的护理，预防非计划性拔管；实施checklist清单交接管理；加强皮肤护理，降低压力性损伤风险；置管侧肢体缺血性损伤的监测及护理；动态调整抗凝策略，加强血栓及出血管理；落实集束化护理措施，防范和控制感染。患者经过18天的精细化治疗与护理后康复出院。
Abstract: This paper summarizes the nursing care of a patient with left ventricular noncompaction complicated with fulminant myocarditis undergoing extracorporeal membrane oxygenation. The key points of nursing care are as follows: dynamic monitoring of changes in the patient’s vital signs during mechanical circulatory assistance; strengthening the care of the tube to prevent unplanned extubation; implementing checklist handover management; strengthening skin care to reduce the risk of pressure injury; monitoring and nursing of ischemic injury of the cannulated limb; dynamically adjusting the anticoagulation strategy, strengthening the management of thrombosis and bleeding; implementing bundled nursing measures to prevent and control infection. The patient recovered and was discharged after 18 days of meticulous treatment and nursing.
文章引用：李瓶芝, 尹礼义. 1例左室心肌致密化不全并发暴发性心肌炎患者行体外膜肺氧合的护理[J]. 临床医学进展, 2024, 14(9): 842-848. https://doi.org/10.12677/acm.2024.1492537

参考文献

[1] Nemes, A. (2023) Myocardial Mechanics and Associated Valvular and Vascular Abnormalities in Left Ventricular Noncompaction Cardiomyopathy. Journal of Clinical Medicine, 13, 78.
[2] 邱庆竹, 谢利剑. 左心室心肌致密化不全致病分子遗传机制研究进展[J]. 儿科药学杂志, 2023, 29(11): 64.
[3] Venkataraman, S., Bhardwaj, A., Belford, P.M., Morris, B.N., Zhao, D.X. and Vallabhajosyula, S. (2022) Veno-Arterial Extracorporeal Membrane Oxygenation in Patients with Fulminant Myocarditis: A Review of Contemporary Literature. Medicina, 58, 215.
[4] 何小龙, 王文鑫, 张鑫, 等. 机械循环辅助装置在爆发性心肌炎中应用的研究进展[J]. 实用医学杂志, 2023, 39(17): 1461-1465.
[5] 郑静, 方振红, 张丽萍. 1例暴发性心肌炎并发肝素诱导血小板减少症病人的护理[J]. 护理研究, 2022, 36(17): 3189-3192.
[6] 柳红娟, 乔莹, 陈晗睿, 等. 2例暴发性心肌炎清醒患者使用体外膜肺氧合联合主动脉内球囊反搏治疗的护理[J]. 中华护理杂志, 2021, 5(12): 1796-1799.
[7] 李云. V-AECMO联合CRRT治疗急性爆发性心肌炎合并多脏器功能衰竭患者的护理[J]. 齐鲁护理杂志, 2020, 26(7): 118-120.
[8] 周超楠, 伍伟锋. 暴发性心肌炎临床研究新进展[J]. 临床心血管病杂志, 2020, 36(11): 978-981.
[9] 李旭琴, 冯洁惠. 1例行机械循环辅助桥接心脏移植患者的术前护理[J]. 中华护理杂志, 2024, 59(9): 1114-1118.
[10] 刘娟娟, 胡光玲. 1例ECMO联合IABP治疗急性心肌梗死的护理[J]. 新疆医学, 2020, 50(9): 996-998.
[11] 邱小英, 石泽亚, 张艳, 等. 1例免疫检查点抑制剂相关暴发性心肌炎患者的护理[J]. 护理实践, 2022, 57(14): 1744-1748.
[12] 尹小雪, 叶钢. 成人外周置管体外膜肺氧合支持过程中出血并发症的危险因素探讨[J]. 临床急诊杂志, 2024, 25(7): 348-351.
[13] 刘艳, 陈志兰, 曹新颖, 等. 下肢灌注评估量表预防股静脉－动脉体外膜氧合患者下肢缺血的护理实践[J]. 中国体外循环杂志, 2023, 21(2): 107-110.
[14] 熊文珍. 护理目标管理预防VV-ECMO并发症的临床观察[J]. 护理实践与研究, 2021, 18(7): 1077-1080.
[15] Martínez-Martínez, M., Nuvials, F.X. and Riera, J. (2022) Nosocomial Infections during Extracorporeal Membrane Oxygenation. Current Opinion in Critical Care, 28, 480-485. [Google Scholar] [CrossRef] [PubMed]
[16] 徐志程, 马玉婷, 郑仁杰, 等. 体外膜肺氧合期间院内感染的研究进展[J]. 临床医学研究与实践, 2024, 9(13): 191-194.

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