北京中医药大学第三附属医院 脑病科, 北京, 100036
高世超, E-mail: 728753722@qq.com
收稿:2025-12-22,
修回:2026-02-04,
录用:2026-02-06,
网络首发:2026-03-11,
移动端阅览
杨露, 高世超. 1例缺血性中风多病共存患者的中西医结合护理报告[DB/OL].中西医结合临床案例库, 2026.
YANG Lu, GAO Shichao. A Report on Integrated Traditional Chinese and Western Medicine Nursing for a Patient with Ischemic Stroke and Multiple Comorbidities[DB/OL].Clinical Archives of Integrative Medicine, 2026.
杨露, 高世超. 1例缺血性中风多病共存患者的中西医结合护理报告[DB/OL].中西医结合临床案例库, 2026. DOI: 10.12209/CAIM202512220003.
YANG Lu, GAO Shichao. A Report on Integrated Traditional Chinese and Western Medicine Nursing for a Patient with Ischemic Stroke and Multiple Comorbidities[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI: 10.12209/CAIM202512220003.
本病例为1例64岁缺血性中风(风痰阻络证)合并冠心病、高脂血症、混合性焦虑抑郁障碍等多重共病患者,存在抗栓治疗矛盾、药物相互作用风险及神经精神共病管理三大难点。针对患者复杂病情,构建中西医结合护理框架,一是建立“舌脉变化—二便情况—生命体征”一体化监测体系,实时评估病情动态;二是创建“肢体麻木程度—穴位压痛评分”模型,指导循经刺络拔罐的精准实施;三是同步运行四维风险精准防控机制。经过系统护理干预,患者实现抗栓药物的安全停药转换,神经功能显著改善,焦虑抑郁症状得到有效缓解,最终顺利出院。本案例为多重共病缺血性中风患者的临床护理提供实践参考,也为中西医结合护理在复杂疾病中的应用积累了经验。
This case report describes a 64-year-old patient with ischemic stroke (wind-phlegm obstructing collaterals syndrome) complicated by coronary heart disease, hyperlipidemia, and mixed anxiety-depressive disorder, presenting three major clinical challenges: antithrombotic therapy contradictions, drug interaction risks, and neuropsychiatric comorbidity management. To address the complexity, an integrated TCM-Western nursing framework was implemented: (1) A unified monitoring system for tongue/pulse changes, bowel/bladder function, and vital signs to dynamically evaluate disease progression; (2) A "limb numbness severity-acupoint tenderness scoring" model to guide precision meridian-based pricking-cupping therapy; (3) A four-dimensional risk prevention-control mechanism. Through systematic nursing interventions, the patient achieved safe transition of antithrombotic medications, significant neurological improvement, and effective alleviation of anxiety-depressive symptoms, culminating in successful discharge. This case provides practical insights for nursing complex ischemic stroke with comorbidities and enriches the application of integrated TCM-Western nursing in multifaceted diseases.
安丹蔷 , 季宇宣 , 张瀚之 , 等 . 下肢康复训练机器人联合等速肌力训练对老年脑卒中偏瘫患者神经功能、步行能力、Lovett肌力分级及平衡能力的影响 [J]. 临床和实验医学杂志 , 2024 , 23 ( 4 ): 377 - 381 .
AN D Q , JI Y X , ZHANG H Z , et al . Effects of lower limb rehabilitation training robot with isokinetic muscle strength training on nerve function, walking ability, Lovett muscle strength classification and balancing ability in elderly stroke patients with hemiplegia [J]. J Clin Exp Med , 2024 , 23 ( 4 ): 377 - 381 . (in Chinese)
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 . 中国急性缺血性卒中诊治指南2023 [J]. 中华神经科杂志 , 2024 , 57 ( 6 ): 523 - 559 .
Neurology Branch of Chinese Medical Association , Cerebrovascular Disease Group of Neurology Branch of Chinese Medical Association . Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2023 [J]. Chin J Neurol , 2024 , 57 ( 6 ): 523 - 559 . (in Chinese)
林衍声 , 林嘉滢 , 周钰馨 . 社区脑卒中患者上肢躯体感觉功能障碍康复中国专家共识(2025版) [J]. 中国医刊 , 2025 , 60 ( 9 ): 1025 - 1034 .
LIN Y S , LIN J Y , ZHOU Y X . Chinese expert consensus on rehabilitation of upper limb somatosensory dysfunction in community-dwelling stroke patients(2025 edition) [J]. Chin J Med , 2025 , 60 ( 9 ): 1025 - 1034 . (in Chinese)
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 . 中国缺血性卒中和短暂性脑缺血发作二级预防指南2022 [J]. 中华神经科杂志 , 2022 , 55 ( 10 ): 1071 - 1110 .
Neurology Branch of Chinese Medical Association , Cerebrovascular Disease Group of Neurology Branch of Chinese Medical Association . Chinese guideline for the secondary prevention of ischemic stroke and transient ischemic attack 2022 [J]. Chin J Neurol , 2022 , 55 ( 10 ): 1071 - 1110 . (in Chinese)
牛永红 , 康林 , 李馨 , 等 . 运用CRUSADE评分系统评估非ST段抬高性急性冠脉综合征患者双重抗血小板治疗后的出血风险 [J]. 岭南心血管病杂志 , 2014 , 20 ( 1 ): 22 - 25 .
NIU Y H , KANG L , LI X , et al . Application of CRUSADE scoring system in assessment of hemorrhage in patients with non-ST-elevation acute coronary syndromes after percutaneous coronary intervention [J]. South China J Cardiovasc Dis , 2014 , 20 ( 1 ): 22 - 25 . (in Chinese)
李九红 , 陈婷 , 黄伶智 , 等 . 3种跌倒风险评估工具对养老机构中老年人跌倒风险的预测价值比较 [J]. 护理研究 , 2024 , 38 ( 13 ): 2296 - 2301 .
LI J H , CHEN T , HUANG L Z , et al . Comparison of predictive value of three fall risk assessment tools among middle-aged and elderly people in nursing facilities [J]. Chin Nurs Res , 2024 , 38 ( 13 ): 2296 - 2301 . (in Chinese)
章琪 , 施忠英 , 李丽 , 等 . 1例难治性抑郁症患者用药安全的护理 [J]. 中华护理杂志 , 2025 , 60 ( 17 ): 2069 - 2072 .
ZHANG Q , SHI Z Y , LI L , et al . Safe medication nursing care for a patient with treatment resistant depression [J]. Chin J Nurs , 2025 , 60 ( 17 ): 2069 - 2072 . (in Chinese)
陈丽勤 , 何华 , 杨雪华 , 等 . 缺血性中风(中经络)患者证素与体质的相关性 [J]. 中国中医急症 , 2025 , 34 ( 8 ): 1350 - 1354 .
CHEN L Q , HE H , YANG X H , et al . Correlation between syndrome elements and constitution in patients with ischemic stroke(apoplexy involving channel and collateral) [J]. J Emerg Tradit Chin Med , 2025 , 34 ( 8 ): 1350 - 1354 . (in Chinese)
应家佩 , 裴华莲 , 周玲玲 , 等 . 中老年慢性肾脏病共病患者数智化主动健康管理方案的构建及应用研究 [J]. 中华护理杂志 , 2025 , 60 ( 21 ): 2591 - 2598 .
YING J P , PEI H L , ZHOU L L , et al . Development and application of a digital-intelligent proactive health management program for middle-aged and elderly patients with chronic kidney disease and comorbidities [J]. Chin J Nurs , 2025 , 60 ( 21 ): 2591 - 2598 . (in Chinese)
陈晓红 , 方国美 , 金丽红 , 等 . 基于三维质量结构模型构建老年失能患者延续护理的质量评价指标体系 [J]. 护士进修杂志 , 2024 , 39 ( 7 ): 686 - 690 .
CHEN X H , FANG G M , JIN L H , et al . Establishment of evaluation index system for continuous care quality in elderly disabled patients based on the three-dimensional quality structure model [J]. J Nurses Train , 2024 , 39 ( 7 ): 686 - 690 . (in Chinese)
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
