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

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