高血脂症性急性胰腺炎误诊急性阑尾炎患者的护理

Nursing experience of acute hyperlipidemic pancreatitis misdiagnosed as acute appendicitis

目的 探讨高血脂症性急性胰腺炎患者病情观察及护理的要点.方法 回顾分析3例高血脂症性急性胰腺炎误诊为急性阑尾炎病例的临床资料,并对护理方法进行总结.结果 3例误诊病例入院时均有明显的三酰甘油水平升高（14.1～61.0 mmol/L）,血标本呈乳糜状脂浊血清,1例存有明显诱发因素,临床特点除右下腹症状、体征外,上腹部症状、体征持续存在,早期B超提示有腹腔积液,血、尿淀粉酶升高不明显.确诊后经严密观察病情、心理护理、营养支持护理、降血脂护理及健康宣教等护理后均痊愈出院.结论 临床护理工作中应提高对高血脂症性胰腺炎的认识,入院后全面的护理评估、仔细病情观察有助临床医生分析、判断病情,综合的护理干预促进疾病康复,重视健康宣教,有效控制血脂,去除诱发因素是疾病防治重点.

Objective To explore the appropriate nursing care of acute hyperlipidemic pancreatitis and increase nursing level.Methods The clinical data of 3 cases of hyperlipidemic pancreatitis misdiagnosed as acute appendicitis were analyzed retrospectively and the nursing experience was summarized.Results The blood sample of all 3 cases represented dramatically high level of serum triglyceride （14.1～61.0 mmol/L）.Obvious inducing factors were observed in one case.Besides upper abdominal symptom and physical sign continued in spite of the right lower abdominal discomfort,ascites was discovered by early B-ultrasound.There was no significant increase of serum or urine amylase.After correct diagnosis,all of the 3 cases recovered well by close observation,mental nursing,anti-hyperlipidemic nursing,drainage nursing and health education.Conclusions The knowledge of hyperlipidemic pancreatitis should be well understood during nursing practice.Comprehensive nursing evaluation and close observation can help doctors to analyze and estimate the disease.Integrated nursing techniques can accelerate the recovery of the patients.Health education,anti-hyperlipidemic therapy,and removal of the inducing factors are the keys of prevention.