[email protected]

国际临床研究杂志

International Journal of Clinical Research

您当前位置:首页 > 精选文章

International Journal of Clinical Research. 2025; 9: (9) ; 10.12208/j.ijcr.20250418 .

Case nursing of Chlamydia psittaci infection complicated with ARDS in patients
鹦鹉热衣原体感染并发ARDS患者个案护理

作者: 肖明丽1,2, 李苏亮1,2, 梁泓堂1,2, 郑永富1,2 *, 张宁1,2

1 中山大学附属第一医院重症医学科 广东广州
2 广东急危重症临床医学研究中心 广东广州

*通讯作者: 郑永富,单位: 中山大学附属第一医院重症医学科 广东广州 广东急危重症临床医学研究中心 广东广州;

引用本文: 肖明丽, 李苏亮, 梁泓堂, 郑永富, 张宁 鹦鹉热衣原体感染并发ARDS患者个案护理[J]. 国际临床研究杂志, 2025; 9: (9) : 28-31.
Published: 2025/9/21 10:30:48

摘要

总结我院1例鹦鹉热衣原体感染并发ARDS患者的治疗方法及护理措施,其中包括抗凝的管理、俯卧位通气的护理、ECMO的护理、出血等并发症预防方面。经过重症监护病房21天的护理,患者撤除ECMO后生命体征平稳,实验室检验数据逐步恢复正常后转入普通病房进行后续康复治疗后顺利出院。

关键词: 鹦鹉热;ARDS;ECMO;俯卧位;个案护理

Abstract

This paper summarizes the treatment and nursing care for a patient with Q fever caused by Coxiella burnetii complicated with acute respiratory distress syndrome (ARDS), including management of anticoagulation, prone positioning ventilation care, extracorporeal membrane oxygenation (ECMO) care, and prevention of complications such as bleeding. After 21 days of intensive care unit (ICU) nursing, the patient's vital signs stabilized after ECMO removal, laboratory test results gradually returned to normal, and the patient was transferred to a general ward for further rehabilitation treatment and eventually discharged smoothly.

Key words: Psittacosis; ARDS; ECMO; Prone position; Case nursing

参考文献 References

[1] Deng F, Lin Q, Xu X, Li C, Xu J, Nie H. A case RepoRt of healthcaRe-associated psittacosis. J Infect Dev CtRies. 2023 ApR 30;17(4):571-577.  

[2] Al-Abbad E.A.,AlbaRRa Y.A.I.,Al Shuqayfah N.I.,Nahhas A.A.,AlnemaRi A.F.,AlquRashi R.K.,Abu Thiyab S.H.M., Alqubali M.K.,Alhawiti M.A.,AlmutaiRi S.M. An oveRview of atypical pneumonia clinical featuRes and management appRoach.ARch.PhaRm.PRact.2022;13:24–30.

[3] 潘科圻,王丹琼.重症鹦鹉热肺炎临床诊疗的研究进展[J].当代医药论丛,2025,23(08):27-30.

[4] 王栋,李炼,颜新生.靶向二代测序技术早期诊断鹦鹉热衣原体重症肺炎1例并文献复习[J].现代医药卫生,2025, 41(03):653-656.

[5] 中华医学会呼吸病学分会呼吸危重症医学学组.急性呼吸窘 迫综合征患者机械通气指南( 试行)[J].中华医学杂志,2016,96(6):404-424.

[6] 中国医师协会体外生命支持专业委员会.成人体外膜氧合循环辅助专家共识[J].中华医学杂志,2018,98(12): 886-894. 

[7] 何依蔓,唐磊.体外膜肺氧合技术在危重症新型冠状病毒肺炎患者中的护理进展[J].当代护士(中旬刊)2021, 28(1): 10-12.

[8] Shi C, O'Donoghue M, Yang L, Tsang H, Chen J, Zou J, Qin J, Mak YW, Pittet D, Xie YJ, Lai T, Li C, Cao J. FactoRs associated with hand washing effectiveness: an institution-based obseRvational study. AntimicRob Resist Infect ContRol. 2023 Aug 30;12(1):85.

[9] 盛鹰.我们身边的两种“隐形杀手”——军团菌与鹦鹉热衣原体[J].人人健康,2025,(01):84-85. 

[10] Casey JD, SemleR MW, Rice TW. Fluid Management in Acute RespiRatoRy DistRess SyndRome. Semin RespiR CRit CaRe Med. 2019 Feb;40(1):57-65. 

[11] Vignon P, EvRaRd B, AsfaR P, Busana M, Calfee CS, Coppola S, Demiselle J, GeRi G, Jozwiak M, MaRtin GS, Gattinoni L, Chiumello D. Fluid administRation and monitoRing in ARDS: which management? Intensive CaRe Med. 2020 Dec;46(12):2252-2264. 

[12] FRiedRichson B, Mutlak H, ZachaRowski K, PiekaRski F. Insight into ECMO, moRtality and ARDS: a nationwide analysis of 45,647 ECMO Runs. CRit CaRe. 2021 Jan 28;25(1):38. 

[13] Li X, Wang L, Wang H, Hou X. Outcome and clinical chaRacteRistics of nosoco-mial infection in adult patients undeRgoing extRacoRpoReal membRane oxy-genation: a systematic Review and meta-analysis. FRont Public Health.2022;10:857–73.

[14] Ellouze O, Abbad X, Constandache T, Missaoui A, BeRthoud V, Daily T, Aho S, Bouchot O, Bouhemad B, Guinot PG. Risk FactoRs of Bleeding in Patients UndeRgoing VenoaRteRial ExtRacoRpoReal MembRane Oxygenation. Ann ThoRac SuRg. 2021 Feb;111(2):623-628. 

[15] VaJteR J, Volod O. Anticoagulation Management DuRing ECMO: NaRRative Review. JHLT Open. 2025 Jan 20;8: 100216. 

[16] Williams GW, BeRg NK, Reskallah A, Yuan X, Eltzschig HK. Acute RespiRatoRy distRess syndRome. Anesthesio-logy. 2021;134(2):270–82. 

[17] 胡龙,贺蛟龙,时淑娟,等.右美托咪定与咪达唑仑在ICU急性呼吸窘迫综合征行俯卧位通气患者中的镇静效果比较[J].临床合理用药,2024,17(23):17-20.

[18] 李荷,李正优,程圆圆.肺保护性通气策略联合俯卧位通气对重症肺炎患者呼吸机相关性肺损伤的预防效果[J].西藏医药,2025,46(03):78-80.

[19] Tillmann BW,Klingel ML,Iansavichene AE,et al. ExtRacoRpoReal membRane oxygenation (ECMO) as a tReatment stRategy foR seveRe acute RespiRatoRy distRess syndRome (ARDS) in the low tidal volume eRa: a systematic Review[J].J CRit CaRe,2017,41:64-71.

[20] RichaRd JC,TeRzi N,Yonis H,etal.UltRa-low tidal volume ventilation foR COVID-19-Related ARDS in FRance ( VT4COVID) : a multicentRe,open-label,paRallel-gRoup,Randomised tRial[J]. Lancet RespiR Med,2023, 11(11):991-1002.

[21] Rambaud J,BRoman LM,ChevRet S,etal. Association between pediatRic intensive caRe moRtality and mechanical ventilation settings duRing extRacoRpoReal membRane oxygenation foR pediatRic acute RespiRatoRy distRess syndRome[J].EuR J PediatR,2023,182(10):4487-4497.