中华护理杂志 ›› 2024, Vol. 59 ›› Issue (5): 601-605.DOI: 10.3761/j.issn.0254-1769.2024.05.013

• 疑难病例护理 • 上一篇    下一篇

1例产气性高毒力肺炎克雷伯菌感染患者的护理

赵巧梅(), 黄冰瑛(), 徐虹霞, 蔡凌云, 周冬儿, 朱焕兵, 丁超   

  1. 310009 杭州市 浙江大学医学院附属第二医院护理部(赵巧梅,黄冰瑛,蔡凌云),肝胆胰外科(周冬儿,朱焕兵,丁超);浙江大学医学院附属邵逸夫医院护理部(徐虹霞)
  • 收稿日期:2023-06-07 出版日期:2024-03-10 发布日期:2024-03-12
  • 通讯作者: 黄冰瑛,E-mail:2503089@zju.edu.cn
  • 作者简介:赵巧梅:女,本科,主管护师,责任组长,E-mail:zhaoqm@zju.edu.cn
  • 基金资助:
    浙江省医药卫生科技项目(2022KY819)

Nursing care of a patient with infection of hypervirulent Klebsiella pneumoniae:a case report

ZHAO Qiaomei(), HUANG Bingying(), XU Hongxia, CAI Lingyun, ZHOU Donger, ZHU Huanbing, DING Chao   

  • Received:2023-06-07 Online:2024-03-10 Published:2024-03-12

摘要:

总结1例罕见的以产气性后腹膜脓肿伴全身多处蜂窝织炎为主要表现的高毒力肺炎克雷伯菌感染致侵袭性综合征合并糖尿病患者的护理。护理要点:酮症酸中毒与感染性休克并发的救护;产气性后腹膜脓肿的观察与护理;全身皮下气肿伴蜂窝织炎的观察与护理;多种致病微生物继发感染的治疗和护理;分阶梯营养支持与血糖管理;ICU获得性衰弱的康复护理。经过治疗和护理,患者入院68 d后病情好转,1个月后复查,转归良好。

关键词: 高毒力肺炎克雷伯菌, 后腹膜脓肿, 蜂窝织炎, 糖尿病, 护理

Abstract:

To summarize the nursing of a diabetic patient with gas-forming retroperitoneal abscess and invasive hypervirulent Klebsiella pneumoniae syndrome. Key points of nursing:rescue of ketoacidosis complicated with septic shock;observation and nursing of gas-forming retroperitoneal abscess;nursing of subcutaneous emphysema and cellulitis;stepwise nutritional support and blood glucose management;rehabilitation nursing of ICU-acquired weakness;precaution against pulmonary embolism. After treatment and nursing,the patient’s condition improved after 68 days of hospitalization,and was transferred to a rehabilitation hospital. The patient was reexamined and recovered well 1 month after discharge.

Key words: Hypervirulent Klebsiella Pneumoniae, Retroperitoneal Abscess, Cellulitis, Diabetes Mellitus, Nursing Care