肝癌患者免疫治疗后发生免疫性肠炎致脓毒性休克的护理  

Nursing care for a liver cancer patient with septic shock induced by immune-related colitis after immunotherapy

作　　者：丁锦玲[1] 杨蕾[1] 沈晓[1] 姜霞娟 DING Jinling;YANG Lei;SHEN Xiao;JIANG Xiajuan

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州市310009

出　　处：《中华急危重症护理杂志》2024年第9期830-833,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(2024KY090)。

摘　　要：总结1例肝癌患者免疫治疗后发生免疫性肠炎致脓毒性休克的护理体会。针对该例患者病情危急、进展迅速,早期实施目标导向治疗策略的液体管理,基于床旁超声个性化评估下腔静脉直径,避免液体复苏相关性损伤;落实免疫治疗毒性管理干预;基于幸福五元素的积极心理干预;实施个性化营养。经过7 d的治疗及护理,患者病情稳定出院。出院后1周随访,患者状况良好。This case report summarizes the nursing experience provided to a liver cancer patient who developed septic shock due to immune-related colitis after immunotherapy.In response to the critical and rapidly progressing condition of the patient,early implementation of goal-directed therapeutic strategies for fluid 1management,personalized assessment of inferior vena cava diameters based on bedside ultrasound to avoid fluid resuscitation related injuries,implementation of immunotherapeutic toxicity managementinterventions,positive psychological interventions based on the Five Elements of Happiness and implementation of personalized nutrition were taken.The patient was hospitalized for 7 days and was discharged after recovery.After one week of follow-up after discharge,the patient's condition was good.

关 键 词：肝癌 免疫性肠炎 脓毒性休克 危重病护理 

分 类 号：R473[医药卫生—护理学]