中华护理杂志 ›› 2026, Vol. 61 ›› Issue (11): 1544-1547.DOI: 10.3761/j.issn.0254-1769.2026.11.015

• 疑难重症护理 • 上一篇    下一篇

1例极重度肥胖胸椎黄韧带骨化术后发生多重并发症患者的护理

江雪莲(), 刘萍, 秦思宜, 张书娟, 庄红霞()   

  1. 中国科学技术大学附属第一医院(安徽省立医院)神经外科 合肥市 230031
  • 收稿日期:2026-01-26 出版日期:2026-06-10 发布日期:2026-06-10
  • *通讯作者: 庄红霞,E-mail:571197056@qq.com
  • 作者简介:江雪莲:女,本科,主管护师,E-mail:332791379@qq.com
    作者贡献声明

    江雪莲:选题设计、论文撰写;刘萍:论文审阅和修改;秦思宜、张书娟:资料收集、文献检索;庄红霞:论文撰写、论文修改

Nursing management of a super morbidly obese patient with multiple postoperative complications following thoracic ligamentum flavum ossification surgery

JIANG Xuelian(), LIU Ping, QIN Siyi, ZHANG Shujuan, ZHUANG Hongxia()   

  1. Department of Neurosurgery,the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230031,China
  • Received:2026-01-26 Online:2026-06-10 Published:2026-06-10
  • * Corresponding author: ZHUANG Hongxia,E-mail:571197056@qq.com

摘要:

总结1例极重度肥胖(BMI为52.07)胸椎黄韧带骨化术后并发急性脊髓功能障碍及感染性休克患者的护理经验。护理要点:实施目标导向的脊髓灌注监测、轴线翻身与体位管理及阶梯式康复训练,开展感染性休克的早期识别与基于理想体重的限制性液体复苏护理,并加强穿透脂肪屏障的气道廓清与呼吸管理以及心理支持与认知保护。经过18 d精心治疗与护理,患者双下肢肌力由0级恢复至Ⅲ级,休克纠正且未发生压力性损伤及呼吸衰竭,顺利出院,随访效果满意。

关键词: 胸椎黄韧带骨化, 急性脊髓损伤, 感染性休克, 极重度肥胖, 护理

Abstract:

This paper summarized the nursing experience of a patient with extreme obesity(BMI 52.07) who developed acute spinal cord dysfunction and septic shock after surgery for thoracic ossification of ligamentum flavum. The key nursing points were as follows:implementing goal-directed spinal cord perfusion monitoring,axial repositioning and positioning management, and stepwise rehabilitation training;performing early identification of septic shock and ideal body weight-based restrictive fluid resuscitation nursing;and strengthening airway clearance penetrating the adipose barrier,respiratory management,as well as psychological support and cognitive protection. After 18 days of meticulous treatment and nursing care,the patient’s bilateral lower limb muscle strength recovered from grade 0 to grade Ⅲ,septic shock was corrected,and no pressure injury or respiratory failure occurred. The patient was discharged uneventfully with satisfactory follow-up outcomes.

Key words: Thoracic Ossification of Ligamentum Flavum, Acute Spinal Cord Injury, Septic Shock, Morbid Obesity, Nursing Care