TIME原则为基础的临床决策支持工具应用于1例EB病毒阳性T/NK淋巴组织增生性疾病致皮肤大面积溃疡患者的护理  

The nursing care of a patient with large skin ulcers caused by EBV positive T/NK-cell lymphoproliferative diseases based on TIME Clinical-Decision-Support-Tool

作　　者：王志新 李聪 张俊杰 马永平 周文华 Wang Zhixin;Li Cong;Zhang Junjie;Ma Yongping;Zhou Wenhua(Outpatient Department of Peking Union Medical College Hospital,Beijing 100730,China;Surgical Outpatient Clinic of Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院门诊部,北京100730 [2]中国医学科学院北京协和医院外科门诊,北京100730

出　　处：《中国实用护理杂志》2024年第31期2461-2466,共6页Chinese Journal of Practical Nursing

基　　金：协和特色临床专科护理质量提升项目(2022-PUMCH-B-130)。

摘　　要：总结TIME原则为基础的临床决策支持工具(CDST)应用于1例EB病毒阳性T/NK淋巴组织增生性疾病致全身多处皮肤大面积溃疡患者的护理经验。护理要点包括早期识别溃疡发生的原因,积极治疗原发病;准确持续地评估患者及其伤口;多学科会诊确保诊疗的整体性和全面性;积极识别障碍因素并进行风险管控;根据不同的伤口愈合阶段提供不同的换药方案,随时评价治疗效果;适时进行疼痛管理;改善患者营养状况;给予患者健康教育及心理护理,提高患者应对能力。经过367 d的伤口换药后患者创面全部愈合,造血干细胞移植后基因检查未检测出EB病毒DNA,患者转归良好。To summarize the nursing experience of a patient with large skin ulcers caused by EBV positive T/NK-cell lymphoproliferative diseases based on TIME Clinical-Decision-Support-Tool.The main points of nursing care were as follows:early identification of the cause of ulceration and active treatment of the underlying disease;accurate and continuous assessment of patients and their wounds;multidisciplinary consultation to ensure the integrity and comprehensiveness of diagnosis and treatment;active identification of obstacle factors and risk control;providing different dressing change programs according to different wound healing stages;evaluation of treatment effects at any time;timely pain management;improving the nutritional status of patients;providing health education and psychological nursing care.After 367 days of wound dressing,the patient′s wound was fully healed,and EBV-DNA was not detected in genetic examination after hematopoietic stem cell transplantation.

关 键 词：护理 EB病毒阳性T/NK淋巴组织增生性疾病 溃疡 慢性伤口 

分 类 号：R473.73[医药卫生—护理学]