Nursing Practice of Integrated Traditional Chinese and Western Medicine and Multidisciplinary Collaboration for a Patient with Cerebral Infarction Complicated with Heart Failure： A Case Report

WANG Ying; SU Ruixia; FENG Wenying

doi:10.12209/CAIM202503070001

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Nursing Practice of Integrated Traditional Chinese and Western Medicine and Multidisciplinary Collaboration for a Patient with Cerebral Infarction Complicated with Heart Failure： A Case Report

更新时间：2025-04-17

- Nursing Practice of Integrated Traditional Chinese and Western Medicine and Multidisciplinary Collaboration for a Patient with Cerebral Infarction Complicated with Heart Failure： A Case Report
- Clinical Archives of Integrative Medicine (2025)
- 作者机构：
  
  1.北京市大兴区中西医结合医院神经内科，北京， 100076
  2.北京市大兴区中西医结合医院护理部，北京， 100076
- 作者简介：
- 基金信息：
- DOI：10.12209/CAIM202503070001
  CLC：
- Received：07 March 2025，
  
  Accepted：2025-04-08，
  
  Published Online：17 April 2025，
- 稿件说明：
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WANG Ying, SU Ruixia, FENG Wenying. Nursing Practice of Integrated Traditional Chinese and Western Medicine and Multidisciplinary Collaboration for a Patient with Cerebral Infarction Complicated with Heart Failure： A Case Report[DB/OL].Clinical archives of integrative medicine, 2025.
DOI：

WANG Ying, SU Ruixia, FENG Wenying. Nursing Practice of Integrated Traditional Chinese and Western Medicine and Multidisciplinary Collaboration for a Patient with Cerebral Infarction Complicated with Heart Failure： A Case Report[DB/OL].Clinical archives of integrative medicine, 2025. DOI： 10.12209/CAIM202503070001.

摘要

脑梗塞合并心力衰竭是临床常见的复杂共病，其护理需兼顾脑灌注与心功能平衡。本文通过1例89岁脑梗死合并心衰患者的护理实践，探讨中西医结合康复护理及多学科协作模式的应用效果。患者入院时存在吞咽障碍（EAT-10评分4分，洼田饮水试验3级）、左侧肢体肌力减退（左上肢3级，左下肢3+级）及心衰急性发作。护理团队通过限制性补液（每日≤1500 mL，滴速≤40滴/min）、代偿性吞咽训练（低头姿势联合增稠饮食）、中医干预（艾灸、耳穴压豆）及多学科动态调控，14 d后患者吞咽功能显著改善（EAT-10评分3分，洼田饮水试验2级），肢体肌力提升（左上肢4级），未发生急性心衰加重或抽搐事件。本案例表明，中西医协同护理与多学科协作可有效解决心脑共病的矛盾需求，为同类患者的个体化管理提供参考。

Abstract

Cerebral infarction complicated with heart failure is a common and complex comorbidity in clinical practice， and its nursing requires balancing cerebral perfusion and cardiac function. This paper explores the application effect of integrated traditional Chinese and Western medicine rehabilitation nursing and multidisciplinary collaboration through the nursing practice of an 89-year-old patient with cerebral infarction and heart failure. The patient was admitted with dysphagia （EAT-10 score of 4， grade 3 in the water swallowing test）， decreased muscle strength in the left limb （grade 3 in the left upper limb and grade 3+ in the left lower limb）， and acute heart failure. The nursing team implemented restrictive fluid administration （≤1500 mL per day， ≤40 drops/min）， compensatory swallowing training （head-down position combined with thickened diet）， traditional Chinese medicine intervention （moxibustion and auricular point pressing）， and dynamic multidisciplinary regulation. After 14 days， the patient's swallowing function significantly improved （EAT-10 score of 3， grade 2 in the water swallowing test）， muscle strength in the left limb increased （grade 4 in the left upper limb）， and no acute heart failure exacerbation or seizure events occurred. This case indicates that integrated traditional Chinese and Western medicine nursing and multidisciplinary collaboration can effectively address the conflicting demands of heart and brain comorbidities， providing a reference for individualized management of similar patients.

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