923ChinEmergCritCareNurs,October2023,Vol.4,No.10atedvasculitistreatedwithextracorporealmembrane中华急危重症护理杂志2023年10月第4卷第10期重症护理研究抗中性粒细胞胞质抗体相关性血管炎患者应用体外膜肺氧合的护理张润节郭红艳【摘要】总结1例抗中性粒细胞胞质抗体相关性血管炎合并弥漫性肺泡出血患者应用ECMO辅助治疗的护理体会。针对该患者氧合难以维持、肺泡持续出血，采取静脉-静脉体外膜肺氧合辅助治疗。护理要点：预防和控制感染、俯卧位通气护理、精准化容量管理、严密监测凝血和出血、阶段式康复运动以及个性化心理支持。其中初期抗凝治疗适用性监测及抗凝治疗后管理是该案例的特点和重点。患者第11天成功撤除体外膜肺氧合，第13天脱离机械通气，第30天转出ICU,17d后顺利出院。【关键词】抗中性粒细胞胞质抗体；肺泡；出血；休体外膜氧合作用；危重病护理Nursingofanti-neutrophilcytoplasmiccantibodyassocioxygenation/ZHANGRunjie,GUOHongyan[Abstract】TosummarizethenursingexperienceofECMOforapatientwithanti-neutrophilcytoplasmicantibody(ANCA)associatedvasculitiscomplicatedwithdiffusealveolarhemorrhage.Itwasdifficulttomaintainoxygenationandthealveolarbleedingcontinued,sovein-veinextracorporealmembraneoxygenationwasusedasadjuvanttherapy.Thekeypointsofnursingincludedinfectionpreventionandcontrol,proneventilationcare,precisionvolumemanagement,closemonitoringofclottingandbleeding,phasedearlymobilization,personalizedpsychologicalsupport.Monitoringofapplicabilityintheearlystageofanticoagulanttherapyandmanagementafteranticoagulanttherapywerethecharacteristicsandfocusofthiscase.ThepatientwassuccessfullyremovedfromECMOonthe1lthdayandwithdrewfrommechanicalventilation2dayslater,andhewastransferredoutofICUonthe3Othdayanddischargedsuccessfully17dayslater.[Keywords]Anti-NeutrophilCytoplasmicAntibody;PulmonaryAlveoli;Hemorrhage;ExtracorporealMembraneOxygenation;CriticalCareNursing抗中性粒细胞胞质抗体（anti-neutrophilcyto-plasmicantibody,ANCA)相关性血管炎是以小血管壁炎症和纤维素样坏死为病理特征，可累及全身多系统的一种自身免疫性疾病，肺脏是主要受累器官之一,严重者表现为肺泡出血"]。弥漫性肺泡出血发生率为6.1%~14.9%，一旦发生短期内可引...
