一例肝移植术后艰难梭菌感染相关性腹泻患者的护理

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目的:总结1例肝移植术后艰难梭菌感染相关性腹泻患者的护理经验。方法:对1例肝移植术后艰难梭菌感染相关性腹泻患者制订个体化护理计划,从感染的预防与控制、免疫抑制方案的调整、标本的采集与送检、肛周皮肤护理、预见性急救护理、肠内肠外营养支持、康复活动指导、心理护理等方面实施护理措施。结果:经过22 d的精心治疗和护理,患者病情好转,每日排黄色软便1~2次,实验室粪便细菌培养结果转阴,解除隔离。结论:针对此类患者护理要点包括感染的预防与控制;严重反复腹泻期间合理调整免疫抑制方案,警惕排斥反应;正确采集与送检标本,确保培养结果无误;密切监测排便情况,实施结构化皮肤护理方案;提高病情警示级别,进行预见性急救护理;联合肠内肠外营养支持,增强抵抗力;制订个体化活动方案,促进康复;运用共享决策理念,全程心理疏导。“,”Objective:To summarize the nursing experience of a patient with diarrhea associated with Clostridium difficile infection after liver transplantation.Methods:To make individualized nursing plan for patients with diarrhea associated with Clostridium difficult infection after liver transplantation. Nursing measures were carried out from the aspects of prevention and control of infection, adjustment of immunosuppression program, collection and delivery of samples, perianal skin care, predictive first aid nursing, enteral and parenteral nutrition support, rehabilitation activity guidance, psychological nursing and so on.Results:After 22 days of careful treatment and nursing, the patient's condition improved, the yellow soft stool was discharged once or twice a day, the results of laboratory fecal bacterial culture turned negative and the isolation was lifted.Conclusions:The main points of nursing for such patients include prevention and control of infection, reasonable adjustment of immunosuppressive program during severe recurrent diarrhea, vigilance of rejection, correct collection and delivery of samples to ensure correct culture results, close monitoring of defecation, implementation of structured skin care program, improvement of condition warning level, predictive first aid nursing, combined with enteral and parenteral nutrition support to enhance resistance. Formulate individual activity plans to promote rehabilitation; use the concept of shared decision-making to guide the whole process of psychological counseling.
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