摘要
本文报道1例急性下壁ST段抬高型心肌梗死合并脑梗死患者的康复护理经验。患者临床特点为起病急、病情凶险,同时累及心脑重要器官,存在呼吸骤停、意识障碍、肢体瘫痪及吞咽功能障碍等多重问题。护理重难点在于需同步保障心脑功能稳定、预防多器官并发症,且需兼顾多阶段功能修复的连续性与安全性。患者经西医规范治疗(抗血小板、调脂、改善心功能、呼吸机辅助呼吸等)联合中医特色护理(中药汤剂、针灸、推拿)及多学科协作的分阶段康复护理干预(急性期心肺脑复苏、过渡期功能训练衔接、居家期康复维持)后,心、肺、脑功能及吞咽功能显著改善。最终患者右侧肢体肌力明显恢复,可独立短途行走,吞咽功能恢复至能自主进食普食,生活自理能力大幅提升(Barthel指数80分),可参与简单社会活动,康复效果显著。
This paper reports the rehabilitation nursing experience of a patient with acute inferior ST-segment elevation myocardial infarction complicated by cerebral infarction.The patient's clinical characteristics included acute onset,critical condition,simultaneous involvement of two vital organs(heart and brain),and multiple problems such as cardiac arrest,disturbance of consciousness,limb paralysis,and swallowing dysfunction.The key points of nursing lie in the need to simultaneously ensure the stability of cardiac and cerebral functions,prevent multi-organ complications,and balance the continuity and safety of multi-stage functional repair.After standardized western medicine treatment(including antiplatelet therapy,lipid regulation,improvement of cardiac function,and ventilator-assisted breathing),combined with Traditional Chinese Medicine(TCM)characteristic nursing(TCM decoctions,acupuncture,and massage)and multidisciplinary collaborative phased rehabilitation nursing interventions(cardiopulmonary and cerebral resuscitation in the acute phase,connection of functional training in the transition phase,and maintenance of rehabilitation in the home-based phase),the patient's cardiac,pulmonary,cerebral,and swallowing functions were significantly improved.Eventually,the muscle strength of the patient's right limb recovered markedly,enabling him to walk short distances independently;his swallowing function recovered to the level of being able to eat regular food independently without aspiration;his ability of daily living was greatly enhanced(Barthel index reached 80 points),and he could participate in simple social activities,showing a remarkable rehabilitation effect.
作者
贾占坤
刘洁
杨桂伶
董环
张晨
高云贺
JIA Zhankun;LIU Jie;YANG Guiling;DONG Huan;ZHANG Chen;GAO Yunhe(Department of Cardiac Medicine,Aerospace Center Hospital,Beijing,100049)
出处
《中西医结合护理》
2026年第1期31-36,共6页
Chinese Journal of Integrative Nursing
关键词
心肌梗死
脑梗死
中西医结合
康复护理
myocardial infarction
cerebral infarction
integrated traditional Chinese and western medicine
rehabilitation nursing
