1例腹腔多器官烧伤合并肝撕裂伤患儿的急救与护理

doi:10.3761/j.issn.0254-1769.2024.13.016

摘要/Abstract

摘要：

总结1例烟花爆炸致腹腔多器官烧伤合并肝撕裂伤患儿的护理经验。护理要点：入院后立即启动多学科创伤救护团队，实施创伤性休克急救措施；实施以目标为导向的液体管理，加速术后肠道功能恢复；积极控制腹腔感染，降低脓毒症休克发生风险；开展精准评估，预防消化道大出血、胆漏、胆囊穿孔、迟发性肠坏死等术后并发症；开展营养筛查与评估，制订个性化营养支持方案；重视疼痛评估，实施个性化镇痛措施；关注患儿心理创伤，提供心理支持。患儿术后36 d好转出院，随访2个月恢复良好。

关键词: 爆炸伤, 烧伤, 腹部损伤, 肝撕裂, 急救, 儿科护理学

Abstract:

To summarize the nursing experience of a pediatric patient with multiple organ burns in the abdominal cavity and liver laceration caused by a fireworks explosion. The following nursing points were implemented：immediate activation of a multidisciplinary trauma rescue team upon admission to initiate emergency measures for traumatic shock；implementation of target-oriented fluid management to expedite postoperative intestinal function recovery；active control of abdominal infection to minimize the risk of septic shock；thorough and accurate assessment was conducted to prevent postoperative complications such as gastrointestinal hemorrhage，bile-leakage，gallbladder perforation，and delayed intestinal necrosis；nutritional screening and assessment was performed to develop personalized nutritional support programs；emphasis should be placed on pain assessment to implement individualized analgesia measures；the provision of high-quality psychological support focusing on addressing psychological trauma. The child was successfully discharged 36 days after surgery and exhibited satisfactory recovery during the two-month follow-up period.

Key words: Explosive Injury, Burn, Abdominal Injuries, Laceration of Liver, First Aid, Pediatric Nursing

沈清清, 李荷君, 张学兵, 杨陈. 1例腹腔多器官烧伤合并肝撕裂伤患儿的急救与护理[J]. 中华护理杂志, 2024, 59(13): 1645-1649.

SHEN Qingqing, LI Hejun, ZHANG Xuebing, YANG Chen. First aid and nursing care of a child with abdominal multi-organ burn complicated with liver laceration[J]. Chinese Journal of Nursing, 2024, 59(13): 1645-1649.

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