1例痂皮性疥疮合并多种基础疾病重症患者的护理

Nursing care of a severe crusted scabies patient with multiple underlying diseases

总结1例痂皮性疥疮合并多种基础疾病重症患者的护理经验。护理要点:基于多学科会诊精准治疗、护理基础疾病;20%硫磺软膏涂抹全身皮肤杀疥螨,严格实施接触隔离;提供呼吸支持及气道管理,改善呼吸衰竭;止痒、止痛,提高患者舒适度;量化评估心理状态和睡眠情况,实施心理护理,改善睡眠质量;落实个体化营养、血糖管理、肺康复方案和针对性随访指导。经过28 d精心照护,患者病情稳定,痂皮性疥疮得到控制,剧烈瘙痒逐渐缓解,睡眠质量得到改善,未发生院内疥疮传播事件,患者转社区医院继续康复治疗。

The nursing experience of a severe crusted scabies patient with multiple underlying diseases based on the multidisciplinary treatment(MDT)mode was reported.To avoid the nosocomial scabies outbreaks and promote disease control,the key points of nursing included:precise treatment and care for underlying diseases based on MDT model;application of 20%sulfur ointment to smear whole body skin to kill scabies mites and strict contact isolation;respiratory support and airway management to improve respiratory failure;alleviation of itching and pain to enhance patient comfort;quantitative assessment of mental state and sleep condition,implementation of psychological nursing to improve sleep quality;to implement individualized nutrition,blood glucose management,pulmonary rehabilitation program and targeted follow-up guidance.After 28 days of meticulous care,the patient’s condition was stable with controlled scabies and gradually alleviated severe itching.Sleep quality was improved,and no scabies transmission occurred in the hospital.The patient was transferred to the community hospital for further rehabilitation.