Application of acute lymphoblastic leukemia relapse with septic shock nursing cases of toe gangrene after norepinephrine
急性淋巴细胞白血病复发合并脓毒性休克患者应用去甲肾上腺素后双足趾坏疽的护理个案

摘要

目的 探讨急性淋巴细胞白血病（ALL）复发合并脓毒性休克患者应用去甲肾上腺素治疗后并发双足趾坏疽的护理要点与效果，为临床类似病例护理提供参考。方法 回顾性分析1例ALL复发合并脓毒性休克患者使用去甲肾上腺素后出现双足趾坏疽的临床资料，针对皮肤完整性受损、感染风险等护理难点，实施个体化护理方案，包括皮肤护理、感染控制、循环维护等措施，评价护理效果。结果 患者双足趾坏疽未进一步进展，感染得到控制，未发生深静脉血栓，焦虑情绪缓解，肌力逐步恢复。结论 对该类患者实施综合护理干预，加强多学科协作与并发症监测，可改善预后，提高护理质量。

Abstract

Objective To explore the nursing points and effects of patients with acute lymphoblastic leukemia (ALL) relapse complicated with septic shock who were treated with norepinephrine and complicated with gangrene of both toes, so as to provide reference for clinical nursing of similar cases.
Methods The clinical data of a patient with ALL relapse complicated with septic shock who developed gangrene of both toes after using norepinephrine were analyzed retrospectively. In view of the nursing difficulties such as skin integrity damage and infection risk, individualized nursing scheme was implemented, including skin care, infection control and circulation maintenance, and the nursing effect was evaluated.
Results The patient’s toe gangrene did not progress further, the infection was controlled, deep venous thrombosis did not occur, anxiety was relieved, and muscle strength gradually recovered.
Conclusion   Comprehensive nursing intervention, multi-disciplinary cooperation and complication monitoring can improve the prognosis and nursing quality.