1例腹腔多器官烧伤合并肝撕裂伤患儿的急救与护理  

First aid and nursing care of a child with abdominal multi-organ burn complicated with liver laceration

作　　者：沈清清[1] 李荷君[2] 张学兵[3] 杨陈[3] SHEN Qingqing;LI Hejun;ZHANG Xuebing;YANG Chen

机构地区：[1]浙江大学医学院附属儿童医院普外/胃肠中心,杭州市310052 [2]浙江大学医学院附属儿童医院遗传与代谢科,杭州市310052 [3]重庆医科大学附属儿童医院日间外科

出　　处：《中华护理杂志》2024年第13期1645-1649,共5页Chinese Journal of Nursing

摘　　要：总结1例烟花爆炸致腹腔多器官烧伤合并肝撕裂伤患儿的护理经验。护理要点:入院后立即启动多学科创伤救护团队,实施创伤性休克急救措施;实施以目标为导向的液体管理,加速术后肠道功能恢复;积极控制腹腔感染,降低脓毒症休克发生风险;开展精准评估,预防消化道大出血、胆漏、胆囊穿孔、迟发性肠坏死等术后并发症;开展营养筛查与评估,制订个性化营养支持方案;重视疼痛评估,实施个性化镇痛措施;关注患儿心理创伤,提供心理支持。患儿术后36 d好转出院,随访2个月恢复良好。To summarize the nursing experience of a pediatric patient with multiple organ burns in the abdominal cavity and liver laceration caused by a fireworks explosion.The following nursing points were implemented:immediate activation of a multidisciplinary trauma rescue team upon admission to initiate emergency measures for traumatic shock;implementation of target-oriented fluid management to expedite postoperative intestinal function recovery;active control of abdominal infection to minimize the risk of septic shock;thorough and accurate assessment was conducted to prevent postoperative complications such as gastrointestinal hemorrhage,bile-leakage,gallbladder perforation,and delayed intestinal necrosis;nutritional screening and assessment was performed to develop personalized nutritional support programs;emphasis should be placed on pain assessment to implement individualized analgesia measures;the provision of high-quality psychological support focusing on addressing psychological trauma.The child was successfully discharged 36 days after surgery and exhibited satisfactory recovery during the two-month follow-up period.

关 键 词：爆炸伤 烧伤 腹部损伤 肝撕裂 急救 儿科护理学 

分 类 号：R473.72[医药卫生—护理学]