糖尿病酮症酸中毒合并应激性心肌病急性循环衰竭患者的护理  

Nursing care of a patient with diabetic ketoacidosis complicated with acute circulatory failure caused by stress cardiomyopathy

作　　者：张帅 陈娟红[1] 姚惠萍[1] ZHANG Shuai;CHEN Juanhong;YAO Huiping

机构地区：[1]浙江省人民医院/杭州医学院附属人民医院重症医学科,杭州市310014

出　　处：《中华急危重症护理杂志》2023年第4期353-355,共3页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技面上项目(2020KY050)。

摘　　要：总结1例糖尿病酮症酸中毒合并应激性心肌病患者发生急性循环衰竭,经体外心肺复苏后,行体外膜肺氧合联合连续性肾脏替代治疗患者的护理体会。针对患者发病时胸痛症状不典型、病情进展迅速等问题,采取在维持患者机体内环境稳定的前提下,及早启动体外心肺复苏并做好护理配合,识别凝血功能紊乱并进行护理;对于血流动力学不稳定且禁翻身患者预防压力性损伤,并针对循环稳定期患者不同疾病阶段给予早期康复运动等措施。经过25 d的治疗及护理,患者病情稳定出院。出院后随访2个月,患者状况良好。To summarize the nursing experience of a patient with diabetic ketoacidosis complicated with stress cardiomyopathy leading to acute circulatory failure and received extracorporeal membrane oxygenation combined with continuous renal replacement therapy after extracorporeal cardiopulmonary resuscitation.In view of the atypical symptoms of chest pain and the rapid progress of the disease at the onset of the disease,extracorporeal cardiopulmonary resuscitation should be initiated as soon as possible and nursing cooperation should be performed under the premise of maintaining the stability of the patient's internal environment,coagulation disorders was identified and nursing care was provided.For the patients with unstable circulation and contradictions of turning over,predictive prevention of pressure injuries was performed,and early rehabilitation exercises were implemented in patients with stable circulation in different disease stages.After 25 days of treatment and nursing,the patient was stable and discharged.After 2 months of follow-up,the patient was in good condition.

关 键 词：糖尿病酮症酸中毒 应激性心肌病 体外膜肺氧合 连续性肾脏替代疗法 危重病护理 

分 类 号：R473.5[医药卫生—护理学]