手术中的决策:尊重患者自主权,尽管患有内心炎的36岁女性的死亡风险很高
Renata Sonnenfeld1, Gianmarco Balestra2, Sandra Eckstein1
1Department of Palliative Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
Journal of surgical case reports
|March 13, 2025
概括
本案例研究表明,以患者为中心的沟通和息护理的整合有助于在注射药物患者的感染性内心炎 (IE) 决策,尽管医疗指示拒绝进行心脏手术.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 抚慰性护理是一种缓解性护理.
背景情况:
- 传染性内心炎 (IE) 是注射药物使用者的常见并发症.
- 该病例涉及一名36岁的女性,她患有IE,影响大动脉和三管门,同时患有心脏植入式电子设备感染.
- 该患者在11周前接受了大动脉和三管置换和心脏起器植入.
研究的目的:
- 在注射药物的患者中呈现复杂的IE病例,具有多个设备和膜感染.
- 突出手术决策中的挑战,当病人拒绝医学上指示的治疗.
- 为了说明缓和护理和以患者为中心的沟通在管理如此复杂的病例中的成功整合.
主要方法:
- 案例报告的呈现方式.
- 详细的手术前沟通策略. 手术前沟通策略.
- 多学科团队讨论,涉及外科,医疗和息护理专家.
- 专注于以患者为中心的知情同意和共享决策.
主要成果:
- 由于最近的广泛的手术和康复史,患者拒绝了推的心脏手术.
- 有效的沟通和跨学科对话促进了共享决策.
- 息治疗成功地被整合到手术管理计划中.
- 该案例强调了将患者的目标与治疗选择相协调的重要性.
结论:
- 在复杂的IE病例中,以患者为中心的沟通和共享决策至关重要,特别是当患者拒绝手术时.
- 将息治疗整合到手术管理中可以改善患者的治疗结果和遵守治疗计划.
- 跨学科的合作对于在传染性内心炎管理中进行具有挑战性的伦理和临床决策至关重要.
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