1例多学科联合治疗血液透析患者并发钙化防御的护理

doi:10.3761/j.issn.0254-1769.2022.07.006

中华护理杂志 ›› 2022, Vol. 57 ›› Issue (7): 807-810.DOI: 10.3761/j.issn.0254-1769.2022.07.006

1例多学科联合治疗血液透析患者并发钙化防御的护理

邵丽芳(), 鄢诚丽(), 俞杰, 鲜雪梅, 毛卓英

322000 义乌市浙江大学医学院附属第四医院血液净化中心（邵丽芳,毛卓英）,骨科（鄢诚丽）,护理部（俞杰）;浙江大学医学院附属邵逸夫医院肛肠外科（鲜雪梅）

收稿日期:2021-09-16 出版日期:2022-04-10 发布日期:2022-03-31
通讯作者: 鄢诚丽,E-mail： yanchengli1208@zju.edu.cn
作者简介:邵丽芳：女,本科,主管护师,E-mail： 850799313@zju.edu.cn
基金资助:
浙江省基础公益研究计划青年基金项目(2018LQ19H0200-10)

Nursing care of a patient complicated with calciphylaxis in hemodialysis treated by multidisciplinary approach

SHAO Lifang(), YAN Chengli(), YU Jie, XIAN Xuemei, MAO Zhuoying

Received:2021-09-16 Online:2022-04-10 Published:2022-03-31

摘要/Abstract

摘要：

总结1例长期维持性血液透析患者治疗12年余并发罕见且威胁生命的钙化防御的护理经验。护理主要内容如下：术前饮食护理,实施个体化的血液透析护理方案,多学科联合治疗下的术后创面护理、疼痛管理、药物治疗、营养支持、个体化的终末期肾病患者钙化防御预防性护理等。患者住院期间共进行2次手术,历时25 d,右上肢功能恢复良好出院,伤口造口门诊规律换药,创面完全愈合。

关键词: 血液透析, 钙化防御, 多学科联合治疗, 护理

Abstract:

The nursing experience of long-term maintenance hemodialysis in a patient with rare and life-threatening calciphylaxis for more than 12 years was summarized. Nursing points include preoperative dietary care,implementation of an individualized hemodialysis nursing program,postoperative wound care,pain management,drug treatment,nutritional support,individualized calciphylaxis preventive care of end stage renal disease（ESRD） patients,etc. under the multidisciplinary approach. During the hospitalization,the patient underwent 2 operations,which lasted 25 days. The right upper limb recovered well and the patient was discharged. Dressing was regularly changed in wound stomy clinic and the wound healed completely.

Key words: Hemodialysis, Calciphylaxis, Multidisciplinary Approach, Nursing Care

邵丽芳, 鄢诚丽, 俞杰, 鲜雪梅, 毛卓英. 1例多学科联合治疗血液透析患者并发钙化防御的护理[J]. 中华护理杂志, 2022, 57(7): 807-810.

SHAO Lifang, YAN Chengli, YU Jie, XIAN Xuemei, MAO Zhuoying. Nursing care of a patient complicated with calciphylaxis in hemodialysis treated by multidisciplinary approach[J]. Chinese Journal of Nursing, 2022, 57(7): 807-810.

参考文献 15

[1]	McCarthy JT, El-Azhary RA, Patzelt MT, et al. Survival,risk factors,and effect of treatment in 101 patients with calciphylaxis[J]. Mayo Clin Proc, 2016, 91(10):1384-1394. DOI PMID
[2]	Brandenburg VM, Evenepoel P, Floege J, et al. Lack of evidence does not justify neglect:how can we address unmet medical needs in calciphylaxis?[J]. Nephrol Dial Transplant, 2016, 31(8):1211-1219. DOI URL
[3]	Udomkarnjananun S, Kongnatthasate K, Praditpornsilpa K, et al. Treatment of calciphylaxis in CKD:a systematic review and meta-analysis[J]. Kidney Int Rep, 2018, 4(2):231-244.
[4]	Brandenburg VM, Kramann R, Rothe H, et al. Calcific uraemic arteriolopathy(calciphylaxis):data from a large nationwide registry[J]. Nephrol Dial Transplant, 2017, 32(1):126-132.
[5]	Nigwekar SU, Kroshinsky D, Nazarian RM, et al. Calciphylaxis:risk factors,diagnosis,and treatment[J]. Am J Kidney Dis, 2015, 66(1):133-146. DOI PMID
[6]	Arrestier R, Dudreuilh C, Remy P, et al. Successful treatment of lung calciphylaxis with sodium thiosulfate in a patient with sickle cell disease:a case report[J]. Medicine, 2016, 95(6):e2768. DOI URL
[7]	Sowers KM, Hayden MR. Calcific uremic arteriolopathy:pathophysiology,reactive oxygen species and therapeutic approaches[J]. Oxid Med Cell Longev, 2010, 3(2):109-121. DOI PMID
[8]	马虹, 孙强, 田卓民. 负压封闭引流技术在42例难治性压疮患者中的应用[J]. 中华护理杂志, 2010, 45(8):696-697.
	Ma H, Sun Q, Tian ZM. Application of vacuum sealing drainage in 42 patients with referectory pressure sores[J]. Chin J Nurs, 2010, 45(8):696-697.
[9]	张彦龙, 王泳, 彭阿钦. 骨搬移联合开放植骨和负压封闭引流技术治疗胫骨感染性骨缺损[J]. 中华创伤杂志, 2017, 33(2):141-146.
	Zhang YL, Wang Y, Peng AQ. Bone transport combined with open bone grafting and vacuum sealing drainage for treatment of infectious tibial bone defect[J]. Chin J Traumatol, 2017, 33(2):141-146.
[10]	中华医学会烧伤外科学分会, 《中华烧伤杂志》编辑委员会. 负压封闭引流技术在烧伤外科应用的全国专家共识(2017版)[J]. 中华烧伤杂志, 2017, 33(3):129-135.
	Chinese Burn Association,Editorial Board of Chinese Journal of Burns. Editorial Board of Chinese Journal of Burns. National expert consensus on the application of negative pressure sealing drainage technology in burn surgery (2017)[J]. Chin J Burns, 2017, 33(3):129-135.
[11]	Nigwekar SU, Wolf M, Sterns RH, et al. Calciphylaxis from nonuremic causes:a systematic review[J]. Clin J Am Soc Nep-hrol, 2008, 3(4):1139-1143.
[12]	Weenig RH, Sewell LD, Davis MDP, et al. Calciphylaxis:natural history,risk factor analysis,and outcome[J]. J Am Acad Dermatol, 2007, 56(4):569-579. PMID
[13]	王玉芹, 刘玉平, 王亚玲, 等. 肝动脉化疗栓塞患者疼痛管理标准流程的构建及实践[J]. 中华护理杂志, 2020, 55(4):558-563.
	Wang YQ, Liu YP, Wang YL, et al. Application and effects of standard operation procedure of pain management in patients with transcatheter arterial chemoembolization[J]. Chin J Nurs, 2020, 55(4):558-563.
[14]	潘喆, 王群敏, 钟紫凤. 高渗盐敷料结合负压封闭引流技术处理腹部术后切口感染1例的护理[J]. 护理与康复, 2015, 14(7):697-698.
	Pan Z, Wang QM, Zhong ZF. Nursing of a case of postoperative abdominal incision infection treated by hypertonic salt dressing combined with negative pressure sealing drainage[J]. J Nurs Rehabil, 2015, 14(7):697-698.
[15]	谢奕, 谢伟基, 张益民. 钙化防御1例[J]. 中国血液净化, 2017, 16(11):786-788.
	Xie Y, Xie WJ, Zhang YM. Calciphylaxis:a case report[J]. Chin J Blood Purif, 2017, 16(11):786-788.

1例多学科联合治疗血液透析患者并发钙化防御的护理

Nursing care of a patient complicated with calciphylaxis in hemodialysis treated by multidisciplinary approach

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 15

相关文章 15

编辑推荐

Metrics

[1]	全殷殷, 张帅, 陈娟红, 刘飞跃, 姚惠萍. ICU患者早期肠内营养耐受性监测系统的构建与应用[J]. 中华护理杂志, 2022, 57(7): 773-778.
[2]	曹丽君, 黄丽华, 蒋建萍, 章琪, 柳元化, 闵雪芬. 医护患共同决策方案在房颤患者预防脑卒中中的应用[J]. 中华护理杂志, 2022, 57(7): 779-784.
[3]	中华护理学会血液净化专业委员会, 上海市护理学会血液净化专业委员会, （执笔：陈静向晶接艳青吴霞珺章海芬黄碧红杨振华梁新蕊曹立云夏京华）. 血液透析安全注射临床实践专家共识[J]. 中华护理杂志, 2022, 57(7): 785-790.
[4]	潘文静, 何文霞, 刘同强, 唐羽裳, 徐宇红, 杭琤, 韩惠芳, 丁钟琴, 陈成. 护联体内血液透析通路标准护理流程的建立及实践[J]. 中华护理杂志, 2022, 57(7): 791-797.
[5]	陈管洁, 张海林, 尹丽霞, 杜晓菊, 张慧嫔, 张永萍, 周起帆. 维持性血液透析合并肌少症患者运动干预方案的构建及应用[J]. 中华护理杂志, 2022, 57(7): 798-806.
[6]	张睿, 高学琴, 林平, 赵振娟, 王旖旎. 经皮冠状动脉介入术后患者心血管健康评分轨迹特征的研究[J]. 中华护理杂志, 2022, 57(7): 816-822.
[7]	黄勤, 张晓波, 顾莺, 胡静, 孔梅婧, 傅唯佳. 儿童静脉输液过程质量监控数据表的构建及应用[J]. 中华护理杂志, 2022, 57(7): 823-826.
[8]	尚超娜, 王剑英, 宋涛, 张俊蕾, 张冬红. 伴非自杀性自伤行为心境障碍青少年患者心理体验的质性研究[J]. 中华护理杂志, 2022, 57(7): 827-833.
[9]	陈一媛, 林敏, 黄美春, 张奕馨, 许晓宇, 林丹丹, 庄耀宁. 福建省ICU护士对呼吸机相关性膈肌功能障碍护理知信行的现状调查[J]. 中华护理杂志, 2022, 57(7): 841-845.
[10]	何娜, 江淑贤, 郑子梅, 周子惠, 纪湧芳, 陈妙霞, 李莉莉. 慢加急性肝衰竭患者低血糖发生现状及危险因素分析[J]. 中华护理杂志, 2022, 57(7): 846-852.
[11]	张燕, 徐敏, 陈丽莉, 余婷, 陈娜, 汪炜健. 1例左心房巨大球形血栓致急性左心衰竭患者围手术期的护理[J]. 中华护理杂志, 2022, 57(7): 859-862.
[12]	崔金锐, 肖琦, 柯键, 鄢建军, 曾铁英. 老年终末期肾病患者共享决策体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(7): 863-871.
[13]	古钰君, 张国增, 冯宪凌, 白杨, 岳岚, 王梦. 癌症患者化疗所致脱发心理体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(7): 872-879.
[14]	高佳, 孙叶飞. 癌症患者家庭照顾者复发恐惧的研究进展[J]. 中华护理杂志, 2022, 57(7): 887-891.
[15]	黄晨杉, 林榕, 陈丽丽, 陈晓欢, 陈美榕, 李红. 围手术期患者口渴不适量表的汉化及信效度检验[J]. 中华护理杂志, 2022, 57(7): 892-896.