中华护理杂志 ›› 2025, Vol. 60 ›› Issue (17): 2145-2149.DOI: 10.3761/j.issn.0254-1769.2025.17.016

• 疑难重症护理 • 上一篇    下一篇

1例极重度肥胖合并多发性骨髓瘤患者癫痫持续状态的护理

曹笑柏(), 王鹏举, 高岚, 王宇娇()   

  1. 130021 长春市 吉林大学第一医院神经内科(曹笑柏,高岚,王宇娇),护理部(王鹏举)
  • 收稿日期:2025-04-10 出版日期:2025-09-10 发布日期:2025-08-29
  • 通讯作者: 王宇娇,E-mail:wyjcome.hi@163.com
  • 作者简介:曹笑柏:女,硕士,主管护师,E-mail:caoxb@jlu.edu.cn
  • 基金资助:
    吉林省科技厅重点研发项目(20240304108SF)

Nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus

CAO Xiaobai(), WANG Pengju, GAO Lan, WANG Yujiao()   

  • Received:2025-04-10 Online:2025-09-10 Published:2025-08-29

摘要:

总结1例极重度肥胖合并多发性骨髓瘤患者癫痫持续状态的护理。护理要点:组建多学科救治小组,精准、多维度地评估肥胖程度;基于患者的肥胖程度,实施目标导向镇静、镇痛策略;优化患者困难气道管理措施和机械通气参数设置,严格实施肺保护性通气策略;进行精细化液体管理,密切监测电解质水平,减少癫痫发作诱因;给予序贯营养联合滋养型喂养,实施个体化肠内营养;开展早期活动,预防深静脉血栓形成;实施皮肤保护策略,构建皮肤安全屏障。经过精心治疗与护理,患者病情好转出院。

关键词: 极重度肥胖, 多发性骨髓瘤, 癫痫持续状态, 护理

Abstract:

To summarize the nursing care for a patient with extremely severe obese and multiple myeloma complicated with status epilepticus. The key points of nursing include:a multidisciplinary rescue team was established to accurately and comprehensively assess the patient’s obesity level;based on the degree of obesity,a goal-directed sedation and analgesia strategy was implemented;airway management measures were optimized for difficult intubation,and lung-protective ventilation strategies were strictly followed with adjusted mechanical ventilation parameters;implementing precise fluid management,closely monitoring electrolyte levels,and reducing triggers for seizure episodes;sequential nutrition support combined with trophic feeding was provided,along with personalized enteral nutrition;early mobilization was initiated to prevent deep vein thrombosis;a skin protection strategy was implemented to establish a safe skin barrier. After meticulous treatment and nursing care,the patient’s condition improved,and she was discharged.

Key words: Extremely Severe Obese, Multiple Myeloma, Status Epilepticus, Nursing Care