Nursing care of a patient with hypopituitarism secondary to pituitary tumor surgery complicated with severe pneumonia

doi:10.3761/j.issn.0254-1769.2024.23.016

Abstract

Abstract:

To summarize the nursing experience of a patient with severe pneumonia complicated with hypopituitarism. Key points of nursing：perform airway management and improve oxygenation index；implementing goal-oriented nutrition support programmes to improve nutritional status；continuously preventing and monitoring the occurrence of pituitary crisis；carrying out early lung rehabilitation training combining traditional Chinese medicine and Western medicine；delivering continuity of care to improve disease management capacity. After 24 days of careful treatment and nursing，the patient gets better and was discharged.

Key words: Intensive Care Unit, Hypopituitarism, Pneumonia, Airway Management, Nursing Care

摘要：

总结1例垂体瘤术后继发垂体功能减退症患者合并重症肺炎的护理经验。护理要点：进行气道管理，提高氧合指数；落实目标导向性营养支持方案；持续性预防与监测垂体危象的发生；早期开展中西医结合肺康复训练；实施延续性护理以提高疾病管理能力。经过24 d精心治疗和护理，患者病情好转出院，复查垂体功能指标正常。

关键词: 重症监护病房, 垂体功能减退症, 肺炎, 气道管理, 护理

CHEN Haoying, ZENG Lirong, DU Xinxin, ZHANG Xing. Nursing care of a patient with hypopituitarism secondary to pituitary tumor surgery complicated with severe pneumonia[J]. Chinese Journal of Nursing, 2024, 59(23): 2915-2918.

陈浩莹, 曾莉容, 杜欣欣, 张星. 1例垂体瘤术后继发垂体功能减退症患者合并重症肺炎的护理[J]. 中华护理杂志, 2024, 59(23): 2915-2918.

References 15

[1]	Melmed S. Pituitary-tumor endocrinopathies[J]. N Engl J Med, 2020, 382(10):937-950.
[2]	张雷. 垂体腺瘤术后垂体功能减退的相关性研究[D]. 衡阳: 南华大学, 2021.
	Zhang L. Correlation study of pituitary hypofunction after pitui-tary adenoma surgery[D]. Hengyang: University of South China, 2021.
[3]	中国医师协会急诊医师分会. 中国急诊重症肺炎临床实践专家共识[J]. 中国急救医学, 2016, 36(2):97-107.
	Emergency Physician Branch of Chinese Medical Doctor Asso-ciation. Expert consensus on clinical practice of emergency severe pneumonia in China[J]. Chin J Crit Care Med, 2016, 36(2):97-107.
[4]	魏文举, 张强, 那海顺. 经鼻高流量氧疗在成人患者中的应用进展[J]. 中华护理杂志, 2016, 51(7):853-857.
	Wei WJ, Zhang Q, Na HS. Application progress of nasal high flow oxygen therapy in adult patients[J]. Chin J Nurs, 2016, 51(7):853-857.
[5]	Lalwani LK, Sharma V, Chaudhry D, et al. Indications for pron-ing in acute respiratory distress syndrome:expanding the hori-zon！[J]. Indian J Crit Care Med, 2020, 24(7):589-591.
[6]	Ding L, Wang L, Ma WH, et al. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS:a multi-center prospective cohort study[J]. Crit Care, 2020, 24(1):28.
[7]	米元元, 蔡喆燚, 刘静, 等. 非气管插管患者清醒俯卧位实施策略中国专家共识(2023)[J]. 中华危重病急救医学, 2023, 35(4):337-351.
	Mi YY, Cai ZY, Liu J, et al. Expert consensus on implemen-tation strategy of awake prone positioning for non-intubated patients in China(2023)[J]. Chin Crit Care Med, 2023, 35(4):337-351.
[8]	中国病理生理危重病学会呼吸治疗学组. 重症患者气道廓清技术专家共识[J]. 中华重症医学电子杂志(网络版), 2020, 6(3):272-282.
	Respiratory Therapy Group of the Chinese Society of Patho-physiology and Critical Care Diseases. Expert consensus of airway clearance in critically ill patients[J]. Chin J Crit Care Intensive Care Med Electron Ed, 2020, 6(3):272-282.
[9]	胡梦阳, 黄海燕, 罗健, 等. 成人ICU患者气道廓清的最佳证据总结[J]. 护理学杂志, 2023, 38(2):16-20.
	Hu MY, Huang HY, Luo J, et al. Best evidence summary of airway clearance in adult ICU patients[J]. J Nurs Sci, 2023, 38(2):16-20.
[10]	游俊杰, 刘波, 陈梦玲, 等. 重症肺炎患者营养管理的最佳证据总结[J]. 中华护理杂志, 2024, 59(13):1616-1623. DOI URL
	You JJ, Liu B, Chen ML, et al. Summary of the best evidence for nutritional management in patients with severe pneumonia[J]. Chin J Nurs, 2024, 59(13):1616-1623. DOI URL
[11]	张丽, 杨婷婷, 史丽萍, 等. 俯卧位通气患者肠内营养管理的最佳证据总结[J]. 中华急危重症护理杂志, 2023, 4(2):112-118.
	Zhang L, Yang TT, Shi LP, et al. Evidence summary of enteral nutrition management in patients with prone position ventila-tion[J]. Chin J Emerg Crit Care Nurs, 2023, 4(2):112-118.
[12]	Yeliosof O, Gangat M. Diagnosis and management of hypopi-tuitarism[J]. Curr Opin Pediatr, 2019, 31(4):531-536. DOI PMID
[13]	Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement:key concepts and advances in pulmonary rehabilitation[J]. Am J Respir Crit Care Med, 2013, 188(8):e13-e64.
[14]	王珍, 张晓谊. 慢性阻塞性肺疾病稳定期中西医肺康复研究进展[J]. 新疆中医药, 2024, 42(1):137-140.
	Wang Z, Zhang XY. Research progress on lung rehabilitation of traditional Chinese and western medicine in stable stage of chronic obstructive pulmonary disease[J]. Xinjiang J Tradit Chin Med, 2024, 42(1):137-140.
[15]	张艳, 高珊, 鲁文菊, 等. 腺垂体功能减退症患者的延续性健康管理[J]. 护理学杂志, 2015, 30(15):26-28.
	Zhang Y, Gao S, Lu WJ, et al. Continuous health management for patients with anterior pituitary hypofunction[J]. J Nurs Sci, 2015, 30(15):26-28.