Emergency Integrated Traditional Chinese and Western Medicine Nursing Practice for a Case of Gas Gangrene with Multiple Organ Dysfunction in an Elderly Patient

XU Jinghan; LIU Ruiyi

doi:10.12209/CAIM202510300003

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Emergency Integrated Traditional Chinese and Western Medicine Nursing Practice for a Case of Gas Gangrene with Multiple Organ Dysfunction in an Elderly Patient

更新时间：2026-02-12

- Emergency Integrated Traditional Chinese and Western Medicine Nursing Practice for a Case of Gas Gangrene with Multiple Organ Dysfunction in an Elderly Patient
- Clinical Archives of Integrative Medicine (2026)
- 作者机构：
  
  重庆市中医院急诊科，重庆， 400021
- 作者简介：
- 基金信息：
- DOI：10.12209/CAIM202510300003
  CLC：
- Received：30 October 2025，
  
  Revised：2025-12-31，
  
  Accepted：04 January 2026，
  
  Online First：12 February 2026，
- 稿件说明：
移动端阅览
XU Jinghan, LIU Ruiyi. Emergency Integrated Traditional Chinese and Western Medicine Nursing Practice for a Case of Gas Gangrene with Multiple Organ Dysfunction in an Elderly Patient[DB/OL].Clinical Archives of Integrative Medicine, 2026.
DOI：

XU Jinghan, LIU Ruiyi. Emergency Integrated Traditional Chinese and Western Medicine Nursing Practice for a Case of Gas Gangrene with Multiple Organ Dysfunction in an Elderly Patient[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI： 10.12209/CAIM202510300003.

摘要

本病例为74岁高龄气性坏疽患者，合并脓毒性休克、Ⅰ型呼吸衰竭、多器官功能损伤，同时存在卒中相关症状，中医辨证属脱病（阳气欲脱证）。病情罕见危重，其诊疗与护理的复杂性对急诊护理提出极高要求。治疗上采用青霉素联合克林霉素抗感染、氧疗、补液扩容等西医对症支持方案，同步实施中西医结合护理干预。护理过程严格遵循护理程序：首先完成全面评估，凝练核心护理问题；基于循证依据、临床经验及家属意愿制定个性化护理计划，明确干预依据与预期目标；实施阶段聚焦生命支持、感染防控、伤口护理、呼吸功能支持及中医辨证施护，细化操作流程确保精准落地；护理评价贯穿全程，通过多维度动态评估效果。本案例通过“评估全面化、诊断核心化、计划循证化、实施精细化、评价动态化”的护理模式，成功控制感染、保护器官功能、规避不良结局，患者顺利转入专科病房并康复。高龄气性坏疽合并多并发症患者的护理需强化核心风险优先级管理，融合中西医护理优势，注重多学科协作与动态评价；本报告构建的标准化护理流程，为临床类似危重罕见病例提供可复制的护理范式，具有重要实践指导价值。

Abstract

This case involves a 74-year-old patient with gas gangrene， complicated by septic shock， type I respiratory failure， multiple organ dysfunction， and stroke-related symptoms. From the perspective of traditional Chinese medicine （TCM）， the syndrome was diagnosed as "tuobing" （syndrome of impending yang exhaustion）. The rare and critical nature of the condition， along with the complexity of diagnosis， treatment， and nursing， posed extremely high demands on emergency care. Treatment included Western medicine symptomatic support such as anti-infection with penicillin combined with clindamycin， oxygen therapy， and fluid resuscitation， accompanied by integrated TCM-Western medicine nursing interventions. The nursing process strictly followed the nursing procedure： first， a comprehensive assessment was conducted to identify core nursing issues； a personalized nursing plan was developed based on evidence-based practice， clinical experience， and family preferences， with clear intervention basis and expected goals； the implementation phase focused on life support， infection control， wound care， respiratory function support， and TCM syndrome-based care， with refined operational procedures to ensure precise delivery； nursing evaluation was conducted throughout the process， with multi-dimensional dynamic assessment of outcomes. Through the nursing model of "comprehensive assessment， core diagnosis， evidence-based planning， refined implementation， and dynamic evaluation，" this case successfully controlled infection， protected organ function， avoided adverse outcomes， and the patient was smoothly transferred to the specialist ward for recovery. Nursing care for elderly patients with gas gangrene and multiple complications requires prioritized management of core risks， integration of TCM and Western medicine nursing advantages， and emphasis on multidisciplinary collaboration and dynamic evaluation. The standardized nursing process constructed in this report provides a replicable nursing paradigm for similar critical and rare clinical cases， with important practical guiding value.

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references

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