1例胰岛素泵导管致皮肤软组织感染伴过敏性皮炎的成人隐匿性自身免疫糖尿病患者的护理经验

Nursing management of skin and soft-tissue infections complicated with allergic dermatitis caused by catheter insertion during continuous subcutaneous insulin infusion in a patient with latent autoimmune diabetes in adults

总结1例胰岛素泵导管致皮肤软组织感染伴过敏性皮炎的成人隐匿性自身免疫糖尿病患者的皮肤及伤口护理经验。护理要点包括:针对伤口护理,前期给予以清创、引流、全身及局部抗感染,后期应用负压伤口疗法,促进伤口愈合;实施腹针联合激光疗法治疗过敏性皮炎的护理经验;根据病情全方位血糖管理,指导患者胰岛素泵规范化自我管理,监测盐酸克林霉素、左氧氟沙星、克林霉素等消炎药物的不良反应,预防并发症;加强心理护理和健康教育。患者经治疗护理16d后好转出院,糖尿病足伤口门诊及微信随访,出院3d后伤口愈合良好,血糖控制稳定。

This paper summarized nursing measures of skin and soft-tissue infections(SSTIs)complicated with allergic dermatitis caused by catheter insertion during continuous subcutaneous insulin infusion(CSII)in a patient with latent autoimmune diabetes in adults(LADA).Key issues of nursing were as follows:debridement,drainage,systemic and local anti-infection in the early stage of skin care,and negative-pressure wound therapy to improve the wound healing in the later stage of skin care;comprehensive blood glucose management including standardized self-management of insulin pump and monitoring on adverse reactions of clindamycin hydrochloride,levofloxacin and clindamycin;enhancement on psychological nursing and health education.The patient was discharged form hospital and the follow-up results showed that the wound was healed and the blood glucose was well-controlled.