1例胃内镜黏膜下剥离术后迟发性出血并发腹腔间隔室综合征患者的急救护理

doi:10.3761/j.issn.0254-1769.2026.02.013

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (2): 244-248.DOI: 10.3761/j.issn.0254-1769.2026.02.013

1例胃内镜黏膜下剥离术后迟发性出血并发腹腔间隔室综合征患者的急救护理

周帅帅(), 王飒, 刘亚洁, 柴晶晶, 闫丹萍, 王钰炜^*()

浙江大学医学院附属第二医院护理部杭州市 310009

收稿日期:2025-07-17 出版日期:2026-01-20 发布日期:2026-01-14
*通讯作者: 王钰炜，E-mail：zrwyw@zju.edu.cn
作者简介:周帅帅：女，本科，主管护师，E-mail：1261553204@qq.com

Emergency nursing care for a patient with delayed hemorrhage complicated by abdominal compartment syndrome following gastric endoscopic submucosal dissection：a case report

ZHOU Shuaishuai(), WANG Sa, LIU Yajie, CHAI Jingjing, YAN Danping, WANG Yuwei^*()

Department of Nursing， Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China

Received:2025-07-17 Online:2026-01-20 Published:2026-01-14
* Corresponding author: WANG Yuwei，E-mail：zrwyw@zju.edu.cn

摘要/Abstract

摘要：

总结1例胃内镜黏膜下剥离术后迟发性出血并发腹腔间隔室综合征患者的急救与护理。护理要点：精准识别内镜黏膜下剥离术后迟发性大出血，快速启动护理干预并推动多学科诊疗；动态鉴别失血性休克与梗阻性休克，实施限制性液体复苏策略；早期识别腹腔间隔室综合征，个性化干预减压。经过多学科的救治和精细化护理，患者住院16 d恢复良好，顺利出院。1个月后随访，患者恢复良好，无呕血、腹胀等再发症状。

关键词: 内镜下黏膜剥离术, 迟发性出血, 腹腔间隔室综合征, 急救护理

Abstract:

This report summarizes the emergency management and nursing care of a patient who developed delayed massive gastrointestinal bleeding complicated by abdominal compartment syndrome following gastric endoscopic submucosal dissection（ESD）. Key nursing points：accurately identification of delayed massive hemorrhage after endoscopic submucosal dissection，rapid initiation of nursing interventions and facilitation of multidisciplinary management；dynamic differentiation between hemorrhagic shock and obstructive shock， implementation of restrictive fluid resuscitation strategies；early recognition of abdominal compartment syndrome（ACS），individualized decompres-sion interventions. With timely multidisciplinary treatment and meticulous nursing care，the patient recovered well after 16 days of hospitalization and was successfully discharged. At 1-month follow-up，the patient recovered well with no recurrent symptoms such as hematemesis or abdominal distension.

Key words: Endoscopic Submucosal Dissection, Delayed Bleeding, Abdominal Compartment Syndrome, Emergency Nursing

周帅帅, 王飒, 刘亚洁, 柴晶晶, 闫丹萍, 王钰炜. 1例胃内镜黏膜下剥离术后迟发性出血并发腹腔间隔室综合征患者的急救护理[J]. 中华护理杂志, 2026, 61(2): 244-248.

ZHOU Shuaishuai, WANG Sa, LIU Yajie, CHAI Jingjing, YAN Danping, WANG Yuwei. Emergency nursing care for a patient with delayed hemorrhage complicated by abdominal compartment syndrome following gastric endoscopic submucosal dissection：a case report[J]. Chinese Journal of Nursing, 2026, 61(2): 244-248.

参考文献 18

[1]	王继龙, 刘揆亮, 孟凡冬, 等. 消化道早期癌内镜黏膜下剥离术质量控制体系的建立及研究进展[J]. 中华消化内镜杂志, 2025, 42(4):266-272.
	Wang JL, Liu KL, Meng FD, et al. Establishment and research progress in quality control systems of endoscopic submucosal dissection for early gastrointestinal cancers[J]. Chin J Dig Endosc, 2025, 42(4):266-272.
[2]	国家消化内镜专业质控中心, 国家消化系统疾病临床医学研究中心(上海), 国家消化道早癌防治中心联盟, 等. 中国内镜黏膜下剥离术相关不良事件防治专家共识意见(2020,无锡)[J]. 中华消化内镜杂志, 2020, 37(6):390-403.
	National Quality Control Center for Digestive Endoscopy, National Clinical Research Center for Digestive Diseases (Shanghai), National Alliance of Early Cancer Prevention and Treatment Centers for Digestive Tract, et al. Chinese expert consensus on the prevention and management of adverse events related to endoscopic submucosal dissection(2020,Wuxi)[J]. Chin J Dig Endosc, 2020, 37(6):390-403.
[3]	朱怡颖, 季梦遥, 沈磊. 胃癌前病变内镜下黏膜剥离术术后迟发性出血的风险评分模型预测[J]. 胃肠病学和肝病学杂志, 2025, 34(2):244-249.
	Zhu YY, Ji MY, Shen L. A risk-prediction model for endos-copic submucosal dissection delayed bleeding of gastric pre-cancerous lesions[J]. Chin J Gastroenterol Hepatol, 2025, 34(2):244-249.
[4]	中华医学会急诊医学分会, 北京医学会急诊医学分会, 北京医学会急救医学专科医师分会, 等. 成人腹腔高压和腹腔间隔室综合征诊治急诊专家共识[J]. 中华急诊医学杂志, 2024, 33(5):604-615.
	Emergency Medicine Branch of Chinese Medical Association, Emergency Physicians Branch of Beijing Medical Association, Emergency Treatment and First Aid Branch of Beijing Medi-cal Doctor Association, et al. Consensus of emergency experts on diagnosis and treatment of adult abdominal hypertension and abdominal compartment syndrome[J]. Chin J Emerg Med, 2024, 33(5):604-615.
[5]	李志茹, 卢芳燕, 吉莉, 等. 护士主导的肝移植患儿腹内压管理方案的构建及应用研究[J]. 中华护理杂志, 2024, 59(19):2319-2325. DOI
	Li ZR, Lu FY, Ji L, et al. Construction and application of a nurse-led intra-abdominal pressure management program in children undergoing liver transplantation[J]. Chin J Nurs, 2024, 59(19):2319-2325. DOI
[6]	朱睿, 马翠云, 闵敏. 消化道早癌内镜黏膜下剥离术术后迟发性出血研究进展[J]. 四川大学学报(医学版), 2022, 53(3):381-385.
	Zhu R, Ma CY, Min M. Research progress in delayed bleeding after endoscopic submucosal dissection of early-stage gastroin-testinal cancer[J]. J Sichuan Univ Med Sci, 2022, 53(3):381-385.
[7]	孙振灿, 周举坤, 张晓彤, 等. 胃内镜黏膜下剥离术后迟发性出血的研究进展[J]. 现代消化及介入诊疗, 2023, 28(8):929-933.
	Sun ZC, Zhou JK, Zhang XT, et al. Research progress of de-layed bleeding after endoscopic submucosal dissection of stomach[J]. Mod Interv Diagn Treat Gastroenterol, 2023, 28(8):929-933.
[8]	Gralnek IM, Stanley AJ, Morris AJ, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage(NVUGIH):European Society of Gastrointestinal Endoscopy(ESGE) guideline-update 2021[J]. Endoscopy, 2021, 53(3):300-332. DOI PMID
[9]	胡琴, 莫伟, 中国研究型医院学会出血专业委员会, 等. 失血性休克急救护理专家共识[J]. 中华介入放射学电子杂志, 2024, 12(3):193-199.
	Hu Q, Mo W, Haemorrhage Professional Committee of Chinese Research Hospital Association, et al. Expert consensus on emergency care for hemorrhagic shock[J]. Chin J Inter Rad (Elec Ed), 2024, 12(3):193-199.
[10]	丁幼芽, 王飒, 闫丹萍, 等. 1例刎颈自杀并发气道阻塞及失血性休克患者的急救护理[J]. 中华护理杂志, 2025, 60(15): 1892-1895. DOI
	Ding YY, Wang S, Yan DP, et al. Emergency nursing care of 1 patient with neck suicide complicated with airway obstruc-tion and hemorrhagic shock[J]. Chin J Nurs, 2025, 60(15): 1892-1895.
[11]	曾妃, 兰美娟, 梁江淑渊, 等. 15例成批特重度烧爆复合伤患者合并腹内高压的临床干预实践[J]. 中华急诊医学杂, 2021, 30(3)351-353.
	Zeng F, Lan MJ, Liang JSY, et al. Clinical intervention prac-tice for intra-abdominal hypertension in 15 cases of mass casualties with critical burn-blast combined injuries[J]. Chin J Emerg Med, 2021, 30(3)351-353.
[12]	陈丽花, 盛青青, 黄瑶, 等. 重症患者腹内高压预防与管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(17):2164-2170. DOI
	Chen LH, Sheng QQ, Huang Y, et al. Summary of best evidence on preventing and management of intra-abdominal hypertension in critically ill patients[J]. Chin J Nurs, 2022, 57(17): 2164-2170. DOI
[13]	Rasheed AM, Amirah MF, Abdallah M, et al. Ramsay sedation scale and richmond agitation sedation: dimensions of critical care nursing[J]. Dimens Crit Care Nurs, 2019, 38(2):90-95. DOI PMID
[14]	中华医学会急诊医学分会, 北京医学会急诊医学分会, 北京医师协会急救医学专科医师分会, 等. 成人腹腔高压和腹腔间隔室综合征诊治中国急诊专家共识(2024)[J]. 中华危重病急救医学, 2024, 36(5):449-460.
	Emergency Medicine Branch of Chinese Medical Association, Emergency Physicians Branch of Beijing Medical Associa-tion, Emergency Treatment and First Aid Branch of Beijing Medical Doctor Association, et al. Emergency expert consensus on diagnosis and treatment of intra-abdominal hypertension and abdominal compartment syndrome in adults in China(2024)[J]. Chin Crit Care Med, 2024, 36(5):449-460. DOI PMID
[15]	Kirkpatrick AW, Roberts DJ, De Waele J, et al. Intra-abdomi-nal hypertension and the abdominal compartment syndrome:updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome[J]. Intensive Care Med, 2013, 39(7):1190-1206. DOI PMID
[16]	Mark G. Abdominal compartment syndrome in adults[EB/OL].(2024-02-08)[2025-07-01]. https://www.uptodate.com/contents/abdominal-compartment-syndrome-in-adults.
[17]	丁光璞, 彭意吉, 杨昆霖, 等. 改良经腹腹腔镜肾盂成形术联合孙氏镜治疗UPJO合并肾结石的初步经验[J]. 中华泌尿外科杂志, 2019, 40(9):680-684.
	Ding GP, Peng YJ, Yang KL, et al. Initial experience of modified transperitoneal laparoscopic pyeloplasty combined with a rigid ureteroscope with a deflectable tip(Sun’s urete-roscope) for the treatment of ureteropelvic junction obstruc-tion with renal calculi[J]. Chin J Urol, 2019, 40(9):680-684.
[18]	卢露, 卢芳燕, 吉莉. 1例肝移植合并腹腔间隔室综合征患儿的护理[J]. 中华护理杂志, 2025, 60(2):240-243. DOI
	Lu L, Lu FY, Ji L. Nursing care of a child with liver trans-plantation combined with abdominal compartment syndrome[J]. Chin J Nurs, 2025, 60(2):240-243.

1例胃内镜黏膜下剥离术后迟发性出血并发腹腔间隔室综合征患者的急救护理

Emergency nursing care for a patient with delayed hemorrhage complicated by abdominal compartment syndrome following gastric endoscopic submucosal dissection：a case report

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 18

相关文章 6

编辑推荐

Metrics

[1]	卢露, 卢芳燕, 吉莉. 1例肝移植合并腹腔间隔室综合征患儿的护理[J]. 中华护理杂志, 2025, 60(2): 240-243.
[2]	周帅帅, 王飒, 闫丹萍, 许书荣, 刘亚洁, 王美玲, 李雨林, 王钰炜. 严重交通伤患者区域协同云端救治模式的构建及护理时效评价[J]. 中华护理杂志, 2025, 60(2): 170-176.
[3]	王钰炜, 周帅帅, 闫丹萍, 刘亚洁, 王美玲, 许书荣, 王飒. 1例严重低体温帕金森病患者合并心律失常的急救护理[J]. 中华护理杂志, 2025, 60(13): 1642-1645.
[4]	姜晓真, 郭爱清, 娄曼曼. 1例孕晚期猝死患者的急救护理[J]. 中华护理杂志, 2024, 59(22): 2789-2793.
[5]	周三连,王丽华,任玉琴,季建红,曹胡玲,陈黎敏. 院内急救快速反应系统的改进与应用[J]. 中华护理杂志, 2021, 56(8): 1151-1157.
[6]	中华护理学会灾害护理专业委员会. 成批创伤患者院内急救护理专家共识[J]. 中华护理杂志, 2020, 55(supplement): 156-161.