急性肺栓塞患者治疗期间下肢血栓脱落的急救护理  

Emergency nursing of thrombus detachment in the lower limbs in a patient with acute pulmonary embolism

作　　者：童佩 王芳[1] 苏化 杜建丽[1] TONG Pei;WANG Fang;SU Hua;DU Jianli

机构地区：[1]浙江大学医学院附属邵逸夫医院呼吸与危重症医学科,杭州市310016

出　　处：《中华急危重症护理杂志》2024年第1期51-54,共4页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技计划项目(2023KY813,2022RC037);2021浙江大学医学院附属邵逸夫医院护理科研项目(202139HLGL)。

摘　　要：总结1例因皮下出血致肺栓塞患者抗凝不充分,发生下肢血栓脱落导致急性肺栓塞加重患者的急救护理。护理要点:动态评估患者肺栓塞危险分层,采取个性化护理措施;动态调整抗凝药物剂量,密切观察出血情况;加强抗凝不充分期间的观察与护理,警惕下肢血栓脱落。在多学科肺栓塞快速反应小组参与下,半小时内将患者转入ICU进一步治疗。经积极抢救,该患者于9 d后转回呼吸内科普通病房,好转出院。To summarize the emergency nursing care for a patient with pulmonary embolism due to subcutaneous bleeding,who has insufficient anticoagulation and thrombus detachment in the lower extremities leading to worsening acute pulmonary embolism.Nursing points:dynamic assessment of patients’pulmonary embolism risk stratification and adoption of personalized nursing measures,dynamic adjustment of anticoagulant drug dosage and close observation of bleeding,strengthening of observation and nursing care during inadequate anticoagulation to prevent dislodgement of lower limb thrombus.With the participation of the rapid response team,the patient was transferred to the intensive care unit for further treatment within half an hour.After active resuscitation,the patient was transferred back to the Department of Respiratory Medicine nine days later,and he was improved and discharged.

关 键 词：肺栓塞 出血 抗凝 抗凝不充分 危重病护理 

分 类 号：R473.5[医药卫生—护理学]