一例重度急性呼吸窘迫综合征行体外膜肺氧合治疗合并深静脉附壁血栓患者的护理

Nursing care of a patient with severe acute respiratory distress syndrome who underwent extracorporeal membrane oxygenation and deep vein mural thrombosis

目的为临床行体外膜肺氧合(ECMO)治疗患者血栓并发症预防与处理提供护理经验。方法总结1例重度急性呼吸窘迫综合征(ARDS)患者行ECMO治疗时合并深静脉附壁血栓的护理。要加强体外生命支持监测,重视血栓评估、监测、预防及处理,给予充分营养支持,指导正确的康复锻炼,加强心理护理等。结果患者未发生不可逆血栓相关性并发症,并于治疗62 d康复出院。结论患者虽发生深静脉附壁血栓,但通过及时有效的治疗和个体化的护理,未造成其他不可逆的并发症,为该类患者的救护提供经验。

Objective To offer experience for preventing thrombosis-related complications in patients receiving extracorporeal membrane oxygenation(ECMO).Methods A case of mural thrombosis occurred in a patient with acute respiratory distress syndrome(ARDS)during ECMO therapy.The key points for nursing included:intensive monitoring of the ECMO parameters,repeated assessment of the thrombosis and appropriate preventive measures,adequate nutritional support,active mobilization and rehabilitation,and psychological care.Results No severe thrombosis-related complication occurred during hospitalization and the patient was discharged 62 days after admission.Conclusion Mural thrombosis related complication could be well prevented with active and individualized nursing.