1例重症伪膜性肠炎患者行粪菌移植的护理

doi:10.3761/j.issn.0254-1769.2022.20.014

中华护理杂志 ›› 2022, Vol. 57 ›› Issue (20): 2526-2530.DOI: 10.3761/j.issn.0254-1769.2022.20.014

1例重症伪膜性肠炎患者行粪菌移植的护理

李芸(), 金爽, 吴静冰, 李红, 陈晓欢, 余涵, 陈美榕()

350000 福州市福建省立医院重症医学二科（李芸,吴静冰,余涵）,护理部（金爽,李红,陈晓欢,陈美榕）

收稿日期:2021-12-17 出版日期:2022-10-20 发布日期:2022-10-24
通讯作者: 陈美榕,E-mail： 1095234844@qq.com
作者简介:李芸：女,硕士,主管护师,E-mail： 532019705@qq.com
基金资助:
福建省科技厅引导性项目(2021Y0051)

Nursing care of a patient with severe pseudomembranous colitis undergoing fecal microbiota transplantation

LI Yun(), JIN Shuang, WU Jingbing, LI Hong, CHEN Xiaohuan, YU Han, CHEN Meirong()

Received:2021-12-17 Online:2022-10-20 Published:2022-10-24

摘要/Abstract

摘要：

总结1例直肠癌根治术后并发肺部感染和伪膜性肠炎患者行粪菌移植的护理经验。护理主要内容如下：第1阶段预防感染加重,包括回肠造瘘口及造瘘液的观察与管理、呼吸功能锻炼、早期活动、营养支持、病情观察;第2阶段粪菌移植护理,包括前期准备、粪菌移植实施要点、粪菌移植后观察与护理。经过精心护理,患者康复出院,随访6个月,患者回肠造瘘液为560~1 050 ml/d,生活自理能力增强,焦虑、抑郁症状改善,生活质量提升。

关键词: 粪菌移植, 重症伪膜性肠炎, 回肠造瘘, 护理

Abstract:

To summarize the nursing care of fecal microbiota transplantation in a patient complicated with pulmonary infection and pseudomembranous colitis after radical resection of rectal cancer. The main contents of nursing are as follows. The first stage is to prevent the aggravation of infection,including the observation and management of ileostomy and ostomy fluid,respiratory function exercise,early functional exercise,nutritional support,and disease observation. The second stage is the care of fecal microbiota transplantation,including preparation for transplantation,the key points of nursing during transplantation,and nursing after transplantation. After careful nursing,the patient has recovered and discharged from the hospital. After 6-month follow-up,the ileostomy fluid was controlled at a normal level of 560-1 050 ml/d,with the enhanced self-care ability and the improved symptoms of anxiety and depression,and the quality of life was improved.

Key words: Fecal Microbiota Transplantation, Severe Pseudomembranous Colitis, Ileostomy, Nursing Care

李芸, 金爽, 吴静冰, 李红, 陈晓欢, 余涵, 陈美榕. 1例重症伪膜性肠炎患者行粪菌移植的护理[J]. 中华护理杂志, 2022, 57(20): 2526-2530.

LI Yun, JIN Shuang, WU Jingbing, LI Hong, CHEN Xiaohuan, YU Han, CHEN Meirong. Nursing care of a patient with severe pseudomembranous colitis undergoing fecal microbiota transplantation[J]. Chinese Journal of Nursing, 2022, 57(20): 2526-2530.

参考文献 15

[1]	谢和宾, 曾鸿, 尹柯, 等. 我国住院腹泻患者艰难梭菌感染率的荟萃分析[J]. 中华医院感染学杂志, 2017, 27(5):961-964.
	Xie HB, Zeng H, Yin K, et al. Prevalence rate of clostridium difficile infection in hospitalized patients with diarrhea in China:a meta-analysis[J]. Chin J Nosocomiology, 2017, 27(5):961-964.
[2]	McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for clostridium difficile infection in adults and children:2017 update by the Infectious Diseases Society of America(IDSA) and Society for Healthcare Epidemiology of America (SHEA)[J]. Clin Infect Dis, 2018, 66(7):e1-e48. DOI URL
[3]	汪韦宏, 崔伯塔, 张发明. 洗涤菌群移植治疗伪膜性肠炎1例临床整合思维分析[J]. 中国实用内科杂志, 2020, 40(10):874-876,880.
	Wang WH, Cui BT, Zhang FM. Washed microbiota transplantation in the treatment of pseudomembranous colitis:one case analysis with the clinical thinking of holistic integrative medicine[J]. Chin J Pract Intern Med, 2020, 40(10):874-876, 880.
[4]	Lee JC, Hung YP, Tsai BY, et al. Severe clostridium difficile infections in intensive care units:diverse clinical presentations[J]. J Microbiol Immunol Infect, 2021, 54(6):1111-1117. DOI URL
[5]	Tixier EN, Verheyen E, Ungaro RC, et al. Faecal microbiota transplant decreases mortality in severe and fulminant clos-tridioides difficile infection in critically ill patients[J]. Aliment Pharmacol Ther, 2019, 50(10):1094-1099. DOI URL
[6]	徐建仙, 徐红贞. 1例小儿伪膜性肠炎行粪菌移植的护理[J]. 中华护理杂志, 2015, 50(5):638-640.
	Xu JX, Xu HZ. Nursing care of a child with pseudomembranous colitis treated by fecal microbiota transplantation[J]. Chin J Nurs, 2015, 50(5):638-640.
[7]	Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis,treatment,and prevention of clostridium difficile infections[J]. Am J Gastroenterol, 2013, 108(4):478-498. DOI URL
[8]	董珊, 袁玲, 陈秋菊, 等. 肠造口周围潮湿相关性皮肤损伤预防与管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(2):223-230.
	Dong S, Yuan L, Chen QJ, et al. Summary of the best evidence for the prevention and management of peristomal moisture-associated skin damage in adults[J]. Chin J Nurs, 2022, 57(2):223-230.
[9]	中华预防医学会医院感染控制分会. 中国艰难梭菌医院感染预防与控制指南[J]. 中华医院感染学杂志, 2018, 28(23):3674-3680.
	Hospital Infection Control Branch of Chinese Preventive Me-dicine Association. Guidelines for the prevention and control of nosocomial infection of clostridium difficile in China[J]. Chin J Nosocomiology, 2018, 28(23):3674-3680.
[10]	Saccheri C, Morawiec E, Delemazure J, et al. ICU-acquired weak-ness,diaphragm dysfunction and long-term outcomes of critically ill patients[J]. Ann Intensive Care, 2020, 10(1):1. DOI PMID
[11]	Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease:chest guideline and expert panel report[J]. Chest, 2016, 149(2):315-352. DOI PMID
[12]	亚洲急危重症协会中国腹腔重症协作组. 重症病人胃肠功能障碍肠内营养专家共识(2021版)[J]. 中华消化外科杂志, 2021, 20(11):1123-1136.
	Asian Acute and Critical Care Association Chinese Collaborative Group for Abdominal Intensive Care. Expert consensus on enteral nutrition for gastrointestinal dysfunction in critically ill patients(2021 edition)[J]. Chin J Dig Surg, 2021, 20(11):1123-1136.
[13]	Wang JW, Kuo CH, Kuo FC, et al. Fecal microbiota transplantation:review and update[J]. J Formos Med Assoc, 2019, 118(Suppl 1):S23-S31. DOI URL
[14]	菌群移植标准化方法学的建立与临床应用中国专家共识[J]. 中华胃肠外科杂志, 2020, 23(增刊1):5-13.
	Chinese expert consensus on establishment and clinical application of standardized methodology for bacterial flora transplantation[J]. Chin J Gas Surg, 2020, 23(Z1):5-13.
[15]	李芹, 朱霞明, 陆茵, 等. 10例粪菌移植治疗重度肠道急性移植物抗宿主病患者的护理[J]. 中华护理杂志, 2019, 54(8):1229-1231. DOI
	Li Q, Zhu XM, Lu Y, et al. Nursing of 10 patients with severe gastrointestinal acute graft versus host disease treated with fecal microbiota transplantation[J]. Chin J Nurs, 2019, 54(8):1229-1231.

1例重症伪膜性肠炎患者行粪菌移植的护理

Nursing care of a patient with severe pseudomembranous colitis undergoing fecal microbiota transplantation

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