关键词: 糖尿病, 慢性溃疡, 高渗高血糖综合征, 感染性休克, 护理

Abstract:

To summarize the nursing care experience for a patient with diabetic chronic neck ulcer with hyperosmolar hyperglycemia syndrome combined with septic shock. Key points of nursing care include：preoperative bundle management of early septic shock,precise liquid control,correction of hypertonic and hyperglycemia levels,anticoagulant management to prevent thrombosis,and management of wound bleeding and exudation to win the opportunity for surgical treatment. A multidisciplinary wound management team was established after surgery to focus on postural management and prevent the occurrence of device-related pressure injuries. Early nutrition support,early mobilization and psychological support were given during hospitalization to accelerate the patient’s recovery. After multidisciplinary treatment and nursing care,the patient’s endotracheal intubation was removed 15 days after admission,vital signs were stable,and blood glucose level became normal. The wound surface changed from yellow and black to red,and tended to heal. No serious complications occurred,and the patient was in good nutrition status. The patient was transferred to the general ward 16 days after admission and discharged 26 days after admission. 3 months follow-up after discharge showed that the wound was healed,the neck skin was intact,and there were no other symptoms of discomfort.

Key words: Diabetes Mellitus, Chronic Ulcer, Hyperosmolar Hyperglycemia Syndrome, Septic Shock, Nursing Care