Nursing care of a patient with amyotrophic lateral sclerosis complicated with esophageal fungal infection

doi:10.3761/j.issn.0254-1769.2021.06.008

Abstract

Abstract:

To summarize the nursing experience of a case of amyotrophic lateral sclerosis complicated with esophageal fungal infection. The key point of nursing is the management of dual nasal feeding tubes,including the dual tubes identification,esophageal flushing nursing,prevention of tube blockage,prevention of reflux aspiration. In addition,the anti-fungal drug care,infection control,respiratory management,psychological care are also strengthened. After 62 days of careful treatment and nursing and 4 gastroscopy evaluations,the patient was successfully cured of fungal esophagitis,and percutaneous endoscopic gastrostomy tube was inserted,ensuring the long-term nutrition supply for the patient.

Key words: Amyotrophic Lateral Sclerosis, Fungal Esophagitis, Dual Nasal Feeding Tubes, Esophageal Flushing, Nursing Care

摘要：

总结1例肌萎缩侧索硬化症患者并发食管真菌感染的护理经验。护理重点是鼻饲管道的管理,包括做好管道识别、食管冲洗护理、预防堵管和反流误吸;加强抗真菌药物的护理,控制感染;防误吸护理;心理护理。经过62 d的精心治疗和护理,成功治愈了真菌性食管炎并经皮置入胃造瘘管,保证了患者的长期营养供应。

关键词: 肌萎缩侧索硬化症, 真菌性食管炎, 鼻饲双管, 食管冲洗, 护理

WANG Minxiu,HUANG Wenxin,LIN Shaoyi. Nursing care of a patient with amyotrophic lateral sclerosis complicated with esophageal fungal infection[J]. Chinese Journal of Nursing, 2021, 56(6): 852-854.

王敏秀,黄温馨,林少宜. 肌萎缩侧索硬化症患者并发食管真菌感染的护理[J]. 中华护理杂志, 2021, 56(6): 852-854.

References 10

[1]	曹军, 彭诗月, 王赛博, 等. 经皮胃造瘘术治疗肌萎缩侧索硬化症吞咽困难51例[J]. 介入放射学杂志, 2017,26(2):147-152.
	Cao J, Peng SY, Wang SB, et al. Percutaneous radiologic gastrostomy for the treatment of dysphagia associated with amyotrophic lateral sclerosis:preliminary results in 51 cases[J]. J Interv Radiol, 2017,26(2):147-152.
[2]	Chiò A, Logroscino G, Traynor BJ, et al. Global epidemiology of amyotrophic lateral sclerosis:a systematic review of the published literature[J]. Neuroepid, 2013,41(2):118-130. DOI URL
[3]	曹军, 何阳, 刘洪强, 等. X线引导下行经皮胃造瘘术治疗口咽部肿瘤导致吞咽困难患者21例[J]. 介入放射学杂志, 2015,24(1):46-50.
	Cao J, He Y, Liu HQ, et al. Fluoroscopy-guided percutaneous gastrostomy for the treatment of dysphagia due to oropharyngeal neoplasm:initial experience in 21 cases[J]. J Interv Radiol, 2015,24(1):46-50.
[4]	Pappas PG, Kauffman CA, Andes DR, et al. Executive summary:clinical practice guideline for the management of Candidiasis:2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis, 2016,62(4):409-417. DOI URL
[5]	郭毅学, 朱晓红. 真菌性食道炎中西医诊疗的相关临床研究[J]. 中国中西医结合消化杂志, 2014,22(7):408-409.
	Guo YX, Zhu XH. Fungal esophagitis of Chinese and western medicine diagnosis and treatment of clinical research[J]. Chin J Integr Tradit West Med Dig, 2014,22(7):408-409.
[6]	Kodsi BE, Wickremesinghe C, Kozinn PJ, et al. Candida esophagitis:a prospective study of 27 cases[J]. Gastroenterology, 1976,71(5):715-719. PMID
[7]	王莹, 高丽媛, 郭延军. 真菌感染性食道炎病原学特点及药敏分析[J]. 中华医院感染学杂志, 2010,20(13):1986-1987.
	Wang Y, Gao LY, Guo YJ. Characteristics of fungi and drug susceptibility of esophagitis infected with fungi[J]. Chin J Nosocomiology, 2010,20(13):1986-1987.
[8]	Cottier F, Sherrington S, Cockerill S, et al. Remasking of Candida albicans beta-Glucan in response to environmental pH is regulated by quorum sensing[J]. mBio, 2019,10(5):1130-1140.
[9]	李秀珍, 陈春梅, 徐爱花, 等. 基于误吸风险评估策略下的分层护理干预在ICU机械通气患者中的应用研究[J]. 中国实用护理杂志, 2019,35(5):367-371.
	Li XZ, Chen CM, Xu AH, et al. Study on application of stratified nursing intervention in ICU mechanical ventilation patients based on aspiration risk assessment strategy[J]. Chin J Prac Nurs, 2019,35(5):367-371
[10]	Zung WW. A Self-rating Depression Scale[J]. Arch Gen Psychiatry, 1965,12:63-70. DOI URL

[1]	SHEN Zhijia, CHEN Xinyu, QIAN Zhijie, YIN Limei. Behavioral characteristics of patients with recurrent hypoglycemia in the degeneracy of blood glucose management：a mixed-methods study [J]. Chinese Journal of Nursing, 2024, 59(9): 1043-1050.
[2]	WANG Limei, LI Lu, LI Yuxia, YU Peng, LUO Qian, ZHANG Chongni. The status and influencing factors of kinesiophobia in patients with diabetic peripheral neuropathic pain [J]. Chinese Journal of Nursing, 2024, 59(9): 1051-1056.
[3]	DING Huimin, DAI Limin, CAI Dongqing, YANG Qun. Potential profile analysis and influencing factors of self-management in prediabetic patients [J]. Chinese Journal of Nursing, 2024, 59(9): 1057-1064.
[4]	LIU Haiting, WANG Yongmei, ZHENG Beibei, CAI Lili, YE Linbin, WU Jiayun, NING Li, LI Yimin, CHEN Weixia. Development and reliability and validity test of a Self-Assessment Scale for Medication Literacy in Patients with Coronary Heart Disease Comorbidity Diabetes [J]. Chinese Journal of Nursing, 2024, 59(9): 1065-1071.
[5]	Allergy and Clinical Immunology Committee of Chinese Research Hospital Association, Allergy Care Group, Chinese Society of Allergology, Chinese Medical Association, Allergy Prevention and Control Committee of Chinese Preventive Medicine Association, （Writing Committee：WANG Qing, LIU Jun, ZHI Fan, WAN Wenjin, TIAN Fengying, HUO Xiaopeng, ZHOU Wenhua YANG Yongshi, WANG Tiantian, SUN Jinlü）. Nursing expert consensus on subcutaneous injection for allergen-specific immunotherapy [J]. Chinese Journal of Nursing, 2024, 59(9): 1080-1083.
[6]	LI Qi, SU Qingqing, ZHANG Yaoyao, WANG Tiantian, LÜ Jing, LI Yake, LI Haiyan. A study on the trajectory and influencing factors of joint awareness in patients with total knee arthroplasty [J]. Chinese Journal of Nursing, 2024, 59(9): 1084-1090.
[7]	LIU Ya, LIU Xiaoqing, YANG Xuening, WANG Ping, LIU Xuekui, LUO Dan. Construction and validation of a risk predictive model for the bowel preparation failure in colonoscopy patients [J]. Chinese Journal of Nursing, 2024, 59(9): 1091-1098.
[8]	LI Xuqin, FENG Jiehui, HUANG Fangfang, YU Chao, LIANG Shiyu, WANG Xiao, LI Xufang, ZHU Han. Nursing care of a patient before operation with mechanical circulation-assisted bridging heart transplantation [J]. Chinese Journal of Nursing, 2024, 59(9): 1114-1117.
[9]	JIA Xiaojing, CHEN Yizhu, XU Zhiying, HE Xia, GENG Chao. Nursing care of a patient with acute myocardial infarction after double knee joint replacement due to alkaptonuria [J]. Chinese Journal of Nursing, 2024, 59(9): 1118-1121.
[10]	CUI Yishuang, HE Xifei, WANG Zhaozhao, CHENG Jie, YANG Weimei, LU Lijuan. Shared decision making in acute coronary syndromes：a scoping review [J]. Chinese Journal of Nursing, 2024, 59(9): 1145-1152.
[11]	YU Liangmeng, YU Xiaoling, LI Jiamei, RUAN Xiaofen. Application progress of evidence mapping in nursing field [J]. Chinese Journal of Nursing, 2024, 59(8): 1021-1025.
[12]	GUO Miaomiao, YAN Tingting, XU Dandan, YUAN Ling. Development and application of a whole course management information system for breast cancer [J]. Chinese Journal of Nursing, 2024, 59(8): 901-908.
[13]	QIAO Wenbo, HOU Sijia, ZHU Keping, LI Yaqin, WU Siyuan, QI Ziyi, WANG Wei. Construction and application of a pelvic floor muscle training program for patients with radical prostatectomy [J]. Chinese Journal of Nursing, 2024, 59(8): 909-915.
[14]	LU Ping, WANG Xiaojie, GUO Hailing. Correlation between preoperative frailty and short-term postoperative complications in elderly breast cancer patients [J]. Chinese Journal of Nursing, 2024, 59(8): 916-921.
[15]	YOU Chaoxiang, JIA Mengying, LI Shuang, CHEN Lili, JING Wendan, KOU Hongyan. A study of longitudinal trajectories and predictive factors of symptom clusters in patients with laparoscopic anal preservation surgery for rectal cancer [J]. Chinese Journal of Nursing, 2024, 59(8): 922-929.