特重度烧伤合并席汉综合征患者应激状态的护理  

Nursing care of a patient with severe burn complicated with Sheehan syndrome in stress state

作　　者：夏一兰[1] 卢福长 陈华清 徐婷 XIA Yilan;LU Fuchang;CHEN Huaqing;XU Ting

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》2023年第9期834-837,共4页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：总结1例特重度烧伤合并席汉综合征患者应激状态的护理体会。针对特重度烧伤合并席汉综合征患者应激状态持续时间长、病情复杂、并发症识别困难等问题,落实休克期合理设定液体复苏目标值以快速准确纠正休克,恢复垂体血供;设定血皮质醇值以指导激素替代治疗用量纠正血压,及时监测体温和血钠变化纠正高热,缩短应激状态持续时间,住院期间识别和处理肠内营养不耐受并采用序贯营养支持方法尽快达到目标喂养量,双重隔离措施以预防耐药菌感染等护理要点。患者于入院第34天创面愈合出院,出院前加强疾病知识宣教和居家安全教育指导,随访1个月,恢复良好。To summarize the nursing experience of a patient with severe burn complicated with Sheehan syndrome in stress state.In order to solve the problems of long duration of stress state,complex condition and difficult identification of complications in patients with extremely severe burn complicated with Sheehan syndrome,we set a reasonable target value of fluid resuscitation in shock stage to quickly and accurately correct shock and restore pituitary blood supply,set a value of blood cortisol to guide hormone replacement therapy to correct blood pressure,timely monitor the changes of body temperature and blood sodium to correct high fever,shorten the duration of stress state.We identified and deal with enteral nutritional intolerance during hospitalization,adopted sequential nutritional support methods to achieve the target feeding amount as soon as possible,and took double isolation measures to prevent drug-resistant bacteria infection.The wound healed and the patient was discharged on the 34th day after admission.We strengthened disease knowledge education and home safety education guidance before discharge,and followed up for one month.The patient recovered well.

关 键 词：特重度烧伤 席汉综合征 应激 生理性 危重病护理 

分 类 号：R473.6[医药卫生—护理学]