1例晚期胃癌患者3级免疫相关性肺炎合并急性肺水肿的护理

Nursing care of a advanced gastric cancer patient with grade 3 checkpoint inhibitors-related pneumonitis complicated with acute pulmonary edema

总结1例晚期胃癌患者出现3级免疫相关性肺炎(checkpoint inhibitors-related pneumonitis,CIP)合并急性肺水肿的护理经验。护理要点包括经鼻高流量氧疗配合体位轮换改善氧合功能、做好出入量管理、多学科合作模式下CIP的分级治疗、营养支持、采取院内继发性感染防控措施、个体化的心理护理及加强出院宣教。经过20 d的积极治疗和精心护理,患者病情好转并顺利出院。1个月后电话随访,状况良好。

The nursing experience of a advanced gastric cancer patient with G3 checkpoint inhibitors-related pneumonitis(CIP)complicated with acute pulmonary edema was summarized in this study.Nursing highlights included position conversion combined with high flow nasal cannula oxygen therapy to improve oxygenation function,good input and output management,graded treatment of CIP under the multidisciplinary team model,nutritional support,taking measures to prevent the outbreak of hospital infection,Implementing individualized psychological care,and strengthening diacharge education.After 20 days of active treatment and careful nursing care,the patient's condition improved and was discharged smoothly.Telephone follow-up was conducted 1 month later and showed the patient was in good condition.