摘要
本文归纳总结1例血液透析导管误入纵隔患者的临床护理经验。该患者经过入院后相关检查，后予行固定导管、适当脱水、减轻心脏容量负荷、预防感染、控制血压、祛痰、规律透析以维持内环境稳定等治疗，并配合临床护理，要点包括：密切监测患者生命体征，及时处理病情变化；严格无菌操作，预防感染；妥善固定导管，预防脱管或移位；做好围血液透析期护理；控制饮食摄入量，做好容量管理；提供有效的心理护理与健康宣教，提高患者的治疗信心等。经对症护理后，患者未发生相关并发症，入院第18日患者情况好转出院。
关键词： 血液透析导管；隧道式涤纶套导管；血液透析；纵隔；护理
Abstract
This article summarizes the clinical nursing experience of a patient with a hemodialysis catheter misplaced into the mediastinum. After admission and relevant examinations, the patient underwent treatments such as catheter fixation, appropriate dehydration, reduction of cardiac volume load, infection prevention, blood pressure control, expectorant administration, and regular dialysis to maintain internal environment stability. Clinical nursing care was also provided, with key points including: closely monitoring the patient's vital signs and promptly addressing changes in condition; strictly adhering to aseptic procedures to prevent infection; properly securing the catheter to prevent detachment or displacement; providing peri-hemodialysis care; controlling dietary intake and managing volume; offering effective psychological care and health education to enhance the patient's confidence in treatment. After symptomatic nursing care, the patient did not experience any related complications and was discharged on the 18th day of admission in a better condition.
Key words： Central venous catheter; Tunnel cuffed catheter; Hemodialysis; Mediastinum; Nursing
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