特重度氢氟酸烧伤患者的急救护理  

Emergency nursing of a patient with extremely severe hydrofluoric acid burn

作　　者：卢福长 夏一兰[1] 陈华清 邵华伟[1] LU Fuchang;XIA Yilan;CHEN Huaqing;SHAO Huawei

机构地区：[1]浙江大学医学院附属第二医院烧伤与创面修复科,杭州市310009

出　　处：《中华急危重症护理杂志》2022年第1期83-85,共3页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：总结1例特重度氢氟酸烧伤患者的护理体会。针对氢氟酸高腐蚀性、高渗透性的特征,急诊明确接触史后协助医生尽早去除创面水疱,实施双途径补钙,以阻断氢氟酸的进一步损害;烧伤早期采取目标导向液体管理,减缓对心脏的毒性作用,密切监测游离钙、氟离子水平;结合床旁连续性肾脏替代治疗,以促进体内氟离子的排出;同时针对氢氟酸烧伤进行性组织坏死的特性,尽早行创面清创修复手术,并落实围术期创面管理;期间患者出现ICU谵妄予落实集束化管理策略。患者入院第18天病情稳定,转普通病房继续使用翻身床行换药治疗,第32天创面愈合出院。To summarize the nursing experience of a patient with severe hydrofluoric acid burn.Responding to the high corrosiveness and high permeability of hydrofluoric acid,the nurses assisted the doctor to remove wound blisters as soon as possible after the exposure history was confirmed in the emergency department,and implemented calcium supplementation by two ways to prevent further damage of hydrofluoric acid.We implemented the goal-oriented fluid management in the early stage of burns to reduce the toxic effects on the heart,closely monitored the levels of free calcium and fluoride,and combined with bedside continuous renal replacement therapy to promote the excretion of fluoride from the body.At the same time,in view of the characteristics of progressive tissue necrosis of hydrofluoric acid burns,the wound debridement and repairing operation were performed as soon as possible,and the perioperative wound management was implemented.As the patient had ICU delirium,the cluster management strategy was implemented.On the 18th day of admission,the patient was in a stable condition and transferred to a general ward to continue turning frame and dressing changing treatment.On the 32th day,the wound was healed and he was discharged.

关 键 词：特重度烧伤 氢氟酸 化学烧伤 急症护理 

分 类 号：R473.6[医药卫生—护理学]