治疗复发性嗜铬细胞瘤期间的护理:病例研究。

IF 3 3区 医学 Q1 NURSING
Nursing in Critical Care Pub Date : 2025-05-01 Epub Date: 2024-10-11 DOI:10.1111/nicc.13165
Minmin Chen, Yaoning Zhuang, Zhicheng Weng, Jingjing Zhuang, Liangying Chen
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引用次数: 0

摘要

背景:嗜铬细胞瘤可发生于多发性内分泌肿瘤 2 型患者,使其手术切除后肿瘤复发的风险增加。目的:我们旨在介绍和讨论复发性嗜铬细胞瘤患者的护理管理:研究设计:病例研究。研究设计:病例研究。我们回顾并从病历中检索了必要的信息:一名 34 岁女性患者,曾患甲状腺髓样癌和嗜铬细胞瘤并发心肌病,6 年前接受过手术切除,因腹痛 1 天入院,被诊断为复发性双侧嗜铬细胞瘤、高血压危象、急性心力衰竭和急性肾功能衰竭。入院 8 小时后,她突然心跳骤停,接受了心肺复苏。随后,她接受了体外膜氧合和持续肾脏替代治疗(CRRT)。肾上腺肿瘤在绝对乙醇消融术后成功接受了明胶海绵颗粒栓塞治疗,这种治疗方法以前从未报道过。她的恢复情况令人满意:结论:应采用综合护理管理方法,包括俯卧位通气;安全运送;密切心肺监测;术前、术中和术后护理;个体化早期康复;以及心理支持,以改善类似病情患者的预后:双侧肾上腺嗜铬细胞瘤可通过绝对乙醇消融术和明胶海绵颗粒栓塞术进行治疗。在围手术期应提供全面的护理管理,包括患者体位、交通、密切监测、早期康复和心理支持等方面的团队合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nursing care during management of recurrent pheochromocytoma: A case study.

Pheochromocytoma can occur in patients with multiple endocrine neoplasia type 2, placing them at increased risk of tumour recurrence after surgical resection. Therefore, management of pheochromocytoma in these patients is a clinical challenge. We aim to present and discuss the nursing management of patient with recurrent pheochromocytoma. Case studies. We reviewed and retrieved the necessary information from the medical records. A 34-year-old female with a history of medullary thyroid carcinoma and pheochromocytoma complicated by cardiomyopathy, who had undergone surgical resections 6 years ago, presented with abdominal pain for 1 day and was diagnosed with recurrent bilateral pheochromocytoma, hypertensive crisis, acute heart failure, and acute renal failure. Eight hours after hospital admission, she experienced sudden cardiac arrest and received cardiopulmonary resuscitations. She was then supported under extracorporeal membrane oxygenation and continuous renal replacement therapy (CRRT). The adrenal tumour was successfully treated with absolute ethanol ablation followed by gelatin sponge particle embolization, a management approach which has not been reported previously. She had a satisfactory recovery. A comprehensive nursing management approach, including prone ventilation; safe transportation; close cardiopulmonary monitoring; pre-, intra- and post-procedure care; individualized early rehabilitation; and psychological supports, should be applied to improve the prognoses in patients with similar medical conditions. Bilateral adrenal pheochromocytoma can be managed by absolute ethanol ablation followed by gelatin sponge particle embolization. Comprehensive nursing management, including a team effort regarding patient positioning, transportation, close monitoring, early rehabilitation and psychological support, should be provided during the peri-procedure period.

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来源期刊
CiteScore
6.00
自引率
13.30%
发文量
109
审稿时长
>12 weeks
期刊介绍: Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice
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