致命性肺血栓栓塞症患者高出血风险下行体外膜肺氧合的护理  

Nursing care of a patient with fatal pulmonary thromboembolism undergoing extracorporeal membrane oxygenation under high bleeding risk

作　　者：李旭琴[1] 黄昉芳[1] 俞超[1] LI Xuqin;HUANG Fangfang;YU Chao

机构地区：[1]浙江大学医学院附属第一医院护理部,杭州市310006

出　　处：《中华急危重症护理杂志》2025年第4期462-465,共4页Chinese Journal of Emergency and Critical Care Nursing

摘　　要：总结1例致命性肺血栓栓塞症患者高出血风险下行体外膜肺氧合的护理。护理要点:高出血风险期间体外膜肺氧合运行的出血风险管理。低抗凝期间的观察与护理包括个体化低抗凝方案的实施与护理、小血栓引起体外膜肺引流不足的应急护理策略、高凝状态下保持下肢远端灌注管通畅,避免下肢缺血。以及在体外膜肺支持下经皮肺动脉取栓术后观察与护理。经过积极抢救,精心治疗与护理,患者好转出院,随访期间,患者恢复良好。To summarize the nursing care of a patient with fatal pulmonary thromboembolism undergoing extracorporeal membrane oxygenation under high bleeding risk.Key points of care included bleeding risk management during extracorporeal membrane oxygenation in periods of high bleeding risk.Observation and nursing during the period of low anticoagulation included the implementation and nursing of individualized low anticoagulation program,emergency nursing strategy for insufficient extracorporeal membrane drainage caused by small thrombus,and keeping the distal perfusion tube of lower limb open in the state of high coagulation to avoid lower limb ischemia.And the observation and nursing after percutaneous pulmonary embolectomy with extracorporeal membrane lung support was implemented.After active rescue,careful treatment and nursing,the patient improved and was discharged from the hospital.During the follow-up,the patient recovered well.

关 键 词：急性肺栓塞 体外膜肺氧合 出血 危重病护理 

分 类 号：R473.5[医药卫生—护理学]