Nursing care of a patient with pulmonary arteriovenous fistula and postoperative acute ischemic stroke

doi:10.3761/j.issn.0254-1769.2024.06.011

Abstract

Abstract:

To summarize the nursing experience of a patient with pulmonary arteriovenous fistula and secondary acute ischemic stroke after surgery. Nursing points include：implementing predictive care to ensure smooth emergency access；accurate evaluation and early identification to seize golden rescue time；strengthening postoperative management and promoting the recovery of important organs；dynamically adjusting anticoagulation strategies to ensure maximum benefit for patients；actively correcting perioperative anemia and preventing complications；implementing continuous care through an intelligent follow-up system to promote physical and mental recovery. The patient was discharged from hospital after multidisciplinary teamwork and careful nursing.

Key words: Lung, Arteriovenous Fistula, Stroke, Surgery, Nursing Care

摘要：

总结1例肺动静脉瘘患者术后继发急性缺血性脑卒中的护理经验。护理要点如下：实施预见性护理，保证应急通道通畅；准确评估与早期识别，抓住黄金抢救时间；加强术后管理，促进重要器官康复；动态调整抗凝策略，保障患者最大获益；积极纠正围手术期贫血，预防并发症；通过智能随访系统实施延续性护理，促进身心康复。该患者经过多学科团队合作及精心护理，康复出院。

关键词: 肺, 动静脉瘘, 卒中, 外科手术, 护理

XIE Xuping, YU Limei, CHEN Mingxiang, LI Fuping, LI Zhiping. Nursing care of a patient with pulmonary arteriovenous fistula and postoperative acute ischemic stroke[J]. Chinese Journal of Nursing, 2024, 59(6): 719-722.

谢徐萍, 余立梅, 陈明祥, 李福平, 李志平. 1例肺动静脉瘘患者术后继发急性缺血性脑卒中的护理[J]. 中华护理杂志, 2024, 59(6): 719-722.

References 12

[1]	杨锦珊, 陈梨花, 饶照增, 等. 肺动静脉瘘相关性脑梗死的临床特点[J]. 中华神经科杂志, 2021, 54(5):455-462.
	Yang JS, Chen LH, Rao ZZ, et al. Clinical characteristics of pulmonary arteriovenous fistula related ischemic stroke[J]. Chin J Neurol, 2021, 54(5):455-462.
[2]	刘明, 姜格宁, 丁嘉安. 肺动静脉瘘的外科治疗[J]. 中国胸心血管外科临床杂志, 2012, 19(2):205-207.
	Liu M, Jiang GN, Ding JA. Surgical treatment of pulmonary arteriovenous fistula[J]. Chin J Clin Thorac Cardiovasc Surg, 2012, 19(2):205-207.
[3]	余洁, 李娟, 田芳, 等. 基于风险感知理论的预见性护理在急性缺血性脑卒中溶栓病人中的应用研究[J]. 全科护理, 2022, 20(29):4095-4097.
	Yu J, Li J, Tian F, et al. Application of predictive nursing based on risk perception theory in patients with acute ischemic stroke undergoing thrombolysis[J]. Chin Gen Pract Nurs, 2022, 20(29):4095-4097.
[4]	中国老年医学学会麻醉学分会. 中国老年患者围术期缺血性脑卒中防治专家共识[J]. 临床麻醉学杂志, 2022, 38(11):1200-1209.
	Chinese Anesthesiology Association of Chinese Geriatric Society. Expert consensus on prevention and treatment of perioperative ischemic stroke in elderly patients in China[J]. J Clin Anesthesiol, 2022, 38(11):1200-1209.
[5]	刘子薇, 关宁笑, 李烨, 等. 《2021 AHA/ASA指南:改善院内脑卒中病人评估和管理的最佳实践》解读[J]. 全科护理, 2022, 20(29):4044-4048.
	Liu ZW, Guan NX, Li Y, et al. Interpretation of “2021 AHA/ASA guidelines:best practices to improve the assessment and management of in-hospital stroke patients”[J]. Chin Gen Pract Nurs, 2022, 20(29):4044-4048.
[6]	中华护理学会内科专业委员会, 首都医科大学宣武医院. 急性缺血性脑卒中静脉溶栓护理指南[J]. 中华护理杂志, 2023, 58(1):10-15. DOI
	Internal Medicine Nursing Committee of Chinese Nursing Association, Xuanwu Hospital Capital Medical University. Nursing guidelines for intravenous thrombolysis in acute ischemic stroke[J]. Chin J Nurs, 2023, 58(1):10-15. DOI
[7]	汤雪琴, 刘继红, 龚思媛, 等. 《急性缺血性脑卒中病人血管内介入治疗围术期护理专家共识》解读[J]. 护理研究, 2022, 36(12):2069-2073.
	Tang XQ, Liu JH, Gong SY, et al. Interpretation of “perioperative nursing of patients with acute ischemic stroke patients undergoing endovascular interventional therapy:an expert consensus”[J]. Chin Nurs Res, 2022, 36(12):2069-2073.
[8]	宫玉翠, 陈洁雅, 李平东, 等. 慢性呼吸疾病肺康复护理专家共识[J]. 中华护理杂志, 2020, 55(5):709-710. DOI
	Gong YC, Chen JY, Li PD, et al. Expert consensus on pulmonary rehabilitation nursing of chronic respiratory diseases[J]. Chin J Nurs, 2020, 55(5):709-710. DOI
[9]	刘晓辉, 宋景春, 张进华, 等. 中国抗血栓药物相关出血诊疗规范专家共识[J]. 解放军医学杂志, 2022, 47(12):1169-1179.
	Liu XH, Song JC, Zhang JH, et al. Chinese experts consensus for standardized diagnosis and treatment of antithrombotic drug-related bleeding[J]. Med J Chin PLA, 2022, 47(12):1169-1179.
[10]	中华医学会外科学分会, 中华外科杂志编辑委员会. 普通外科围手术期缺铁性贫血管理多学科专家共识[J]. 中华外科杂志, 2020, 58(4):252-256.
	Chinese Surgery Association of Chinese Medical Association, Editorial Committee of the Chinese Journal of Surgery. Multidisciplinary expert’s consensus on the management of perioperative iron deficiency anemia in patients accepting general surgery[J]. Chin J Surg, 2020, 58(4):252-256.
[11]	陈玲, 黄素芳, 熊杰, 等. 脓毒症相关性贫血护理干预的研究进展[J]. 中华急危重症护理杂志, 2022, 3(3):280-283.
	Chen L, Huang SF, Xiong J, et al. Research progress of nursing interventions for sepsis-associated anemia[J]. Chin J Emerg Crit Care Nurs, 2022, 3(3):280-283.
[12]	赵庆, 吴茜, 孙晓, 等. 脑卒中患者延续性护理质量评价指标体系的构建[J]. 中华护理杂志, 2020, 55(2):171-176. DOI
	Zhao Q, Wu Q, Sun X, et al. Development of evaluation index system of continuous care for stroke patients[J]. Chin J Nurs, 2020, 55(2):171-176. DOI

[1]	MU Tingyu, XU Rixiang, ZHU Qianyin, CHEN Lingshan, HUANG Junping, LI Zhimin, SHEN Cuizhen. Construction and preliminary application of a lifestyle decision support system for population with high-normal blood pressure [J]. Chinese Journal of Nursing, 2024, 59(6): 654-661.
[2]	ZHANG Xin, YIN Wei, LIU Qiaoyan, JIN Huayi, ZU Houjuan. Longitudinal relationship between family support and glucose management decision-making behaviours in patients with gestational diabetes mellitus [J]. Chinese Journal of Nursing, 2024, 59(6): 669-676.
[3]	LI Shuhua, SHANG Linping, YUAN Lirong, YIN Wenhui, WEN Jinqi. The sinicization of the Leading a Culture of Quality for Infection Prevention Scale and the test of its reliability and validity [J]. Chinese Journal of Nursing, 2024, 59(6): 713-718.
[4]	REN Hongmei, ZENG Li, HUANG Jing. Nursing care of a patient with renal amyloidosis complicated with severe erythroderma [J]. Chinese Journal of Nursing, 2024, 59(6): 723-726.
[5]	YAN Yu, GONG Shu, DUAN Difei, MA Dengyan. Application and progress of knowledge graphs in dietary management of patients with chronic diseases [J]. Chinese Journal of Nursing, 2024, 59(6): 753-757.
[6]	DENG Yifan, WANG Jianning, PENG Mengting, HONG Du. Decision aids for care decision making in dementia patients：a scoping review [J]. Chinese Journal of Nursing, 2024, 59(6): 758-763.
[7]	HUANG Yongqi, TIAN Xia, WANG Zheng, SUN Mimi, ZHOU Liqun, XIAO Wenli. Disease coping experience of patients with advanced cancer from the perspective of sense of coherence：a qualitative study [J]. Chinese Journal of Nursing, 2024, 59(5): 526-532.
[8]	CHENG Lin, LI Yuanyuan, PEI Bei, LI Huan, LIU Jinlong, XU Yulu, FENG Xinyue, LOU Yan. The volunteering experience of palliative care volunteers：a meta-synthesis of qualitative studies [J]. Chinese Journal of Nursing, 2024, 59(5): 547-555.
[9]	ZHANG Miaomiao, ZHANG Li, YAN Rong, DING Min, MENG Xiangmin, XU Ping. Application progress of online grief counseling in palliative care [J]. Chinese Journal of Nursing, 2024, 59(5): 556-561.
[10]	CHE Xu, QIAO Dongge, WANG Hongxia, CAO Qizheng, CUI Rongrong, CAO Ning. Construction and validation of structural equation modeling of factors influencing treatment adherence in maintenance hemodialysis patients [J]. Chinese Journal of Nursing, 2024, 59(5): 562-568.
[11]	TIAN Siying, LI Suai, LIU Mengrao, LI Peipei, ZHANG Xinyue, CHANG Hong. Qualitative research on emotional experience of mild cognitive impairment patients participating in cognitive intervention based on virtual reality technology [J]. Chinese Journal of Nursing, 2024, 59(5): 569-575.
[12]	LIU Zhiwei, MEI Yongxia, ZHANG Zhenxiang, LIN Beilei, CHEN Suyan, ZHANG Dudu, XUE Lihong, YUAN Yan, ZHANG Weihong. A qualitative study of disease communication experiences in couples with stroke [J]. Chinese Journal of Nursing, 2024, 59(5): 576-581.
[13]	YU Kunrong, LI Fan, HOU Qingmin, XU Yingzhen, LI Xiaorong, MA Jun, CHEN Yan, GUAN Yuxia. The effect of reducing frequency of gastric residual volume monitoring on enteral nutrition in ICU patients [J]. Chinese Journal of Nursing, 2024, 59(5): 582-587.
[14]	ZHAO Qiaomei, HUANG Bingying, XU Hongxia, CAI Lingyun, ZHOU Donger, ZHU Huanbing, DING Chao. Nursing care of a patient with infection of hypervirulent Klebsiella pneumoniae：a case report [J]. Chinese Journal of Nursing, 2024, 59(5): 601-605.
[15]	XIANG Xiaoyan, ZHU Wei, QIN Xiaoying, HUANG Peipei, LU Qi, ZHANG Ye, CUI Zhiping. Application research of ultrasound oblique axis plane guidance technique in PICC puncture [J]. Chinese Journal of Nursing, 2024, 59(4): 389-394.