1.北京市健宫医院 重症医学科, 北京, 100054
2.北京市健宫医院 内分泌科, 北京, 100054
张雪, E-mail: 953783181@qq.com
收稿:2025-06-30,
修回:2026-01-03,
录用:2026-01-04,
网络首发:2026-02-28,
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李文贺, 张雪. 1例重症肺炎合并烟瘾戒断反应患者的纸筒代烟替代疗法护理报告[DB/OL].中西医结合临床案例库, 2026.
LI Wenhe, ZHANG Xue. Report on the Nursing Care of a Patient with Severe Pneumonia Complicated with Nicotine Withdrawal Syndrome[DB/OL].Clinical Archives of Integrative Medicine, 2026.
李文贺, 张雪. 1例重症肺炎合并烟瘾戒断反应患者的纸筒代烟替代疗法护理报告[DB/OL].中西医结合临床案例库, 2026. DOI: 10.12209/CAIM202506300003.
LI Wenhe, ZHANG Xue. Report on the Nursing Care of a Patient with Severe Pneumonia Complicated with Nicotine Withdrawal Syndrome[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI: 10.12209/CAIM202506300003.
本文报道1例67岁男性重症肺炎合并慢性阻塞性肺疾病(COPD)患者在ICU治疗期间出现的烟草依赖戒断综合征及创新护理干预实践。患者有40年吸烟史,日均吸烟2包,入院后严格戒烟,随即出现严重戒断症状,包括焦虑、手部震颤、注意力难以集中及呼吸急促症状加重。医疗团队在常规治疗基础上,创新性实施“纸筒模拟吸烟行为”替代疗法,同时配合呼吸功能训练与心理行为干预。干预72 h后,患者戒断症状明显缓解,临床戒断症状量表(COWS)评分从18分降至7分;呼吸功能显著改善,动脉血氧合指数由125.5升至215,成功实现住院治疗期间完全戒烟。本文通过总结该例重症肺炎合并烟草依赖戒断综合征患者的行为替代疗法护理实践体会,证实了简单行为替代疗法在危重症患者戒烟干预中的显著效果,尤其对无法使用药物替代疗法的危重症患者具有重要的临床借鉴价值。
This article reports on the case of a 67-year-old male patient with severe pneumonia and chronic obstructive pulmonary disease (COPD) who experienced a nicotine dependence withdrawal syndrome during ICU treatment. The patient had a 40-year history of smoking, with an average of 2 packs per day. After strict smoking cessation upon admission, severe withdrawal symptoms occurred, including anxiety, hand tremors, difficulty concentrating, and exacerbated shortness of breath. The medical team implemented an innovative "paper tube simulated smoking behavior" substitution therapy on the basis of routine treatment, along with respiratory function training and psychological behavior intervention. After 72 hours of intervention, the patient's withdrawal symptoms were significantly relieved, with the Clinical Withdrawal Symptoms Scale (COWS) score dropping from 18 points to 7 points; respiratory function improved significantly, with the arterial oxygenation index increasing from 125.5 to 215, successfully achieving complete smoking cessation during hospitalization. Through summarizing the nursing practice experience of this case of a patient with severe pneumonia and nicotine dependence withdrawal syndrome, this article confirms the significant effect of simple behavior substitution therapy in smoking cessation intervention for critically ill patients, especially having important clinical reference value for critically ill patients who cannot use drug substitution therapy.
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