从危机到康复:关于E型肝炎心脏骤停后护理策略的案例报告
Rong Xu1, Junjun Wu1, Lili Dong1
1Department of Gastroenterology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China.
Medicine
|September 9, 2025
概括
这一案例凸显出,由于输血传播的乙型肝炎病毒 (HEV) 感染的风险,在接受体外膜氧化 (ECMO) 的患者中,对肝功能和凝血的警监测至关重要. 多模式护理干预有效地管理了ECMO后的急性HEV,确保了患者的康复和心脏安全.
科学领域:
- 关键护理医学 关键护理医学
- 传染病 传染病 传染病
- 肝病学 肝病学是一种肝病学.
背景情况:
- 身体外膜氧化 (ECMO) 需要大量输血,增加输血相关感染的风险.
- 肝炎E病毒 (HEV) 是一种新兴的输血传染病原体,特别是在缺乏常规查的紧急情况下.
- 对于ECMO后的急性HEV感染,有效的护理策略尚不清楚.
研究的目的:
- 描述ECMO后患有急性肝炎E病毒感染的患者的护理和临床管理.
- 突出早期诊断和重症患者中HEV感染的多模式干预的重要性.
- 强调协调护理在管理复杂的ECMO后并发症中的作用.
主要方法:
- 一名接受ECMO治疗的患者出现了急性HEV感染,通过下一代测序和临床表现得到证实.
- 干预措施包括肝功能和凝血的密集监测,胃肠道管理 (Bacillus licheniformis,乳糖) 和个性化营养.
- 心脏随访包括在稳定后计划植入可植入心脏转换器除器 (ICD) 的植入.
主要成果:
- 患者的肝功能和凝血在49天内恢复正常,黄消失.
- 在术后第50天进行了成功的ICD植入.
- 随访显示没有慢性肝损伤,6个月后HEV-IgM阴性,没有心脏事件.
结论:
- 在ECMO患者中早期发现HEV感染需要监测肝功能,凝血 (PT) 和临床症状 (发烧,黄).
- 多式干预措施,包括肠肝轴调节和量身定制的营养,对于经过ECMO后的急性HEV管理是有效的.
- 协作式,多学科的护理确保了肝脏恢复和长期心脏安全的最佳结果,包括适当的时间进行ICD植入等手术.
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