中国中医科学院广安门医院 脾胃病科, 北京, 100053
梁芳, E-mail: 13001287300@126.com
收稿:2026-06-16,
修回:2026-07-28,
录用:2026-07-30,
网络首发:2026-10-16,
移动端阅览
石雪, 梁芳. 1例肝硬化失代偿期伴双下肢重度水肿患者的中西医结合护理[DB/OL].中西医结合临床案例库, 2026.
SHI Xue, LIANG Fang. Integrated Traditional Chinese and Western Medicine Nursing Care for a Patient with Decompensated Cirrhosis Complicated by Severe Bilateral Lower Extremity Edema: A Case Report[DB/OL].Clinical Archives of Integrative Medicine, 2026.
石雪, 梁芳. 1例肝硬化失代偿期伴双下肢重度水肿患者的中西医结合护理[DB/OL].中西医结合临床案例库, 2026. DOI: 10.12209/CAIM202606160015.
SHI Xue, LIANG Fang. Integrated Traditional Chinese and Western Medicine Nursing Care for a Patient with Decompensated Cirrhosis Complicated by Severe Bilateral Lower Extremity Edema: A Case Report[DB/OL].Clinical Archives of Integrative Medicine, 2026. DOI: 10.12209/CAIM202606160015.
本文总结1例肝硬化失代偿期伴双下肢重度水肿患者的中西医结合护理实践经验,为临床同类患者的护理提供循证参考。针对1例66岁肝硬化失代偿期伴双下肢重度水肿患者,在保肝、利尿及纠正低蛋白血症等西医常规治疗基础上,同步落实体液管理、皮肤防护、营养支持与病情监测等西医护理措施,联合中药内服调理、穴位贴敷及中医情志护理等中医特色干预技术,全程动态评估病情变化与护理效果。经21 d规范化治疗与中西医协同护理,患者双下肢重度水肿完全消退,肝功能、血清白蛋白及电解质指标较入院时显著改善,住院期间未发生压疮、感染或肝性脑病等并发症,病情稳定顺利出院。由此可见,对肝硬化失代偿期伴双下肢重度水肿患者实施针对性中西医结合护理,可有效缓解水肿症状、改善肝功能、降低并发症发生风险并促进患者康复,提升护理质量。
This paper summarizes the clinical nursing experience of integrated Traditional Chinese and Western medicine (TCM-WM) care for a patient with decompensated cirrhosis complicated by severe bilateral lower extremity edema, aiming to provide evidence-based references for the management of similar cases. A 66-year-old patient with decompensated cirrhosis presenting with severe bilateral lower extremity edema was treated with conventional Western medical interventions including hepatoprotection, diuresis, and correction of hypoalbuminemia. In parallel, Western nursing measures encompassing fluid management, skin protection, nutritional support, and condition monitoring were implemented, complemented by characteristic TCM interventions such as oral herbal decoctions, acupoint application, and emotional nursing based on TCM theory. Dynamic assessment of disease progression and nursing outcomes was performed throughout the treatment course. Following 21 days of standardized treatment and coordinated TCM-WM nursing care, the patient's severe bilateral lower extremity edema resolved completely. Liver function, serum albumin, and electrolyte parameters improved markedly compared with admission values. No complications such as pressure ulcers, infection, or hepatic encephalopathy occurred during hospitalization, and the patient was discharged in stable condition. These findings indicate that the implementation of targeted integrated TCM-WM nursing care for patients with decompensated cirrhosis complicated by severe bilateral lower extremity edema can effectively alleviate edema symptoms, improve liver function, reduce the risk of complications, and promote patient recovery, thereby enhancing the overall quality of nursing care.
中华医学会肝病学分会 . 肝硬化临床诊治管理指南(2025版) [J]. 中华肝脏病杂志 , 2025 , 33 ( 10 ): 958 - 976 .
Chinese Society of Hepatology . Clinical Diagnosis, Treatment and Management Guidelines for Liver Cirrhosis (2025 Edition) [J]. Chinese Journal of Hepatology , 2025 , 33 ( 10 ): 958 - 976 . (in Chinese)
中国中西医结合学会消化系统疾病专业委员会 , 刘成海 , 邢枫 , 等 . 肝硬化腹水中西医结合诊疗专家共识(2025年) [J]. 中国中西医结合消化杂志 , 2025 , 33 ( 4 ): 371 - 381 .
The Digestive System Diseases Professional Committee of the Chinese Society of Integrated Traditional Chinese and Western Medicine , Liu C H , Xing F , et al . Expert consensus on integrated traditional Chinese and western medicine diagnosis and treatment of cirrhotic ascites(2025) [J]. Chin J Integr Tradit West Med Dig , 2025 , 33 ( 4 ): 371 - 381 . (in Chinese)
Mahoney F I , Barthel D W . Functional evaluation: the barthel index [J]. Md State Med J , 1965 , 14 : 61 - 65 .
Morse J M , Morse R M , Tylko S J . Development of a scale to identify the fall-prone patient [J]. Can J Aging , 1989 , 8 ( 4 ): 366 - 377 .
Bergstrom N , Braden B J , Laguzza A , et al . The braden scale for predicting pressure sore risk [J]. Nurs Res , 36 ( 4 ): 205 - 210 .
王宪波 , 高方媛 , 刘尧 , 等 . 肝硬化中医诊疗指南 [J]. 临床肝胆病杂志 , 2024 , 40 ( 3 ): 461 - 472 .
Wang X B , Gao F Y , Liu Y , et al . Guidelines for traditional Chinese medicine diagnosis and treatment of liver cirrhosis [J]. J Clin Hepatol , 2024 , 40 ( 3 ): 461 - 472 . (in Chinese)
海峡两岸医药卫生交流协会全科医学分会 , 浙江省医学会全科医学分会 , 浙江省数理医学学会全科未分化疾病专委会 , 等 . 水肿诊治与管理专家共识(2025) [J]. 中国全科医学 , 2025 , 28 ( 31 ): 3861 - 3878 .
General Practice Branch of CrossStraits Medicine Exchange Association ; General Practice Branch of Zhejiang Medical Association , General Undifferentiated Disease Professional Committee of Zhejiang Soc , et al . Expert consensus on the diagnosis, treatment, and management of edema(2025) [J]. Chin Gen Pract , 2025 , 28 ( 31 ): 3861 - 3878 . (in Chinese)
章黎 , 王新颖 . 《中国成人患者肠外肠内营养临床应用指南(2023版)》解读 [J]. 肿瘤代谢与营养电子杂志 , 2023 , 10 ( 6 ): 718 - 723 .
Zhang L , Wang X Y . Interpretation of Guideline for clinical application of parenteral and enteral nutrition in adults patients in China(2023 edition) [J]. Electron J Metab Nutr Cancer , 2023 , 10 ( 6 ): 718 - 723 . (in Chinese)
Zung W W . A rating instrument for anxiety disorders [J]. Psychosomatics , 1971 , 12 ( 6 ): 371 - 379 .
胡建华 , 贾建伟 , 吕文良 , 等 . 肝硬化中西医结合诊疗指南 [J]. 临床肝胆病杂志 , 2023 , 39 ( 11 ): 2543 - 2549 .
Hu J H , Jia J W , Lv W L , et al . Guidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of liver cirrhosis [J]. J Clin Hepatol , 2023 , 39 ( 11 ): 2543 - 2549 . (in Chinese)
李静 , 王玉婷 , 张城浩 , 等 . 肾病综合征水肿患者内服柴苓汤与外敷芒硝的疗效及安全性分析 [J]. 中医药学报 , 2026 , 54 ( 3 ): 68 - 73 .
Li J , Wang Y T , Zhang C H , et al . Analysis of the efficacy and safety of oral chailing decoction combined with external mirabilite application in patients with nephrotic syndrome edema [J]. Acta Chin Med Pharmacol , 2026 , 54 ( 3 ): 68 - 73 . (in Chinese)
徐倩倩 , 张海姣 , 闫娜 , 等 . 肝硬化患者饮食管理与抑郁情绪的关联性及临床管理研究进展 [J]. 国际精神病学杂志 , 2026 , 53 ( 3 ): 704 - 706 .
Xu Q Q , Zhang H J , Yan N , et al . Research progress on the relationship between diet management and depression in patients with liver cirrhosis and clinical management [J]. J Int Psychiatry , 2026 , 53 ( 3 ): 704 - 706 . (in Chinese)
谭冰倩 , 刘铭 , 刘赞 , 等 . 肝硬化患者饮食管理及影响因素的研究进展 [J]. 中西医结合肝病杂志 , 2025 , 35 ( 5 ): 651 - 655 .
Tan B Q , Liu M , Liu Z , et al . The research progress of dietary management and related factors in patients with cirrhosis [J]. Chin J Integr Tradit West Med Liver Dis , 2025 , 35 ( 5 ): 651 - 655 . (in Chinese)
乔莉莉 . 肝硬化腹水患者的饮食指南 [J]. 科学生活 , 2025 ( 11 ): 108 .
Qiao L L . Dietary guidelines for patients with ascites due to cirrhosis [J]. Sci Lifestyle , 2025 ( 11 ): 108 . (in Chinese)
康巧 . 中医情志护理联合正念减压护理对乙肝肝硬化失代偿期患者心理状态及生存质量的影响 [J]. 黑龙江中医药 , 2025 , 54 ( 1 ): 292 - 294 .
Kang Q . Effect of emotional nursing of traditional Chinese medicine combined with mindfulness decompression nursing on psychological state and quality of life of patients with decompensated hepatitis B cirrhosis [J]. Heilongjiang J Tradit Chin Med , 2025 , 54 ( 1 ): 292 - 294 . (in Chinese)
刘国茹 , 张晓辉 , 李卫君 , 等 . 肝硬化失代偿期病人自我管理的证据总结 [J]. 循证护理 , 2026 , 12 ( 3 ): 453 - 459 .
Liu G R , Zhang X H , Li W J , et al . Evidence summary of self-management in patients with decompensated cirrhosis [J]. Chin Evid Based Nurs , 2026 , 12 ( 3 ): 453 - 459 . (in Chinese)
付晓芳 , 陈姣 , 屈波 , 等 . 中西医结合治疗慢性心力衰竭伴双下肢水肿临床观察 [J]. 中国中医急症 , 2017 , 26 ( 12 ): 2208 - 2210 .
Fu X F , Chen J , Qu B , et al . Clinical observation on the combination of traditional Chinese medicine and western medicine on edema of both lower limbs in heart failure [J]. J Emerg Tradit Chin Med , 2017 , 26 ( 12 ): 2208 - 2210 . (in Chinese)
李大艳 , 滕飞 , 孙海燕 . 穴位贴敷联合芒硝外敷对急性胰腺炎胃肠功能恢复的疗效观察 [J]. 皖南医学院学报 , 2025 , 44 ( 4 ): 401 - 405 .
Li D Y , Teng F , Sun H Y . Observation on the efficacy of acupoint application plus external application of mirabilite on gastrointestinal function recovery in patients with acute pancreatitis [J]. J Wannan Med Coll , 2025 , 44 ( 4 ): 401 - 405 . (in Chinese)
于琴 , 周娟 , 赵以琳 , 等 . 中医外治法治疗不孕症临床研究进展 [J]. 河南中医 , 2021 , 41 ( 12 ): 1923 - 1927 .
Yu Q , Zhou J , Zhao Y L , et al . Clinical research progress of external treatments of TCM for infertility [J]. Henan Tradit Chin Med , 2021 , 41 ( 12 ): 1923 - 1927 . (in Chinese)
张桂芳 , 刘真亚 , 高石娟 , 等 . 神阙穴穴位贴敷联合中药热奄包在脑卒中患者功能性便秘中的应用 [J]. 中国实用神经疾病杂志 , 2026 , 29 ( 5 ): 591 - 595 .
Zhang G F , Liu Z Y , Gao S J , et al . Application of Shenque acupoint application combined with Chinese medicine hot compress in functional constipation of stroke patients [J]. Chin J Pract Nerv Dis , 2026 , 29 ( 5 ): 591 - 595 . (in Chinese)
孔海英 . 大柴胡汤化裁内服加芒硝外敷辅治轻症急性胰腺炎临床观察 [J]. 实用中医药杂志 , 2026 , 42 ( 3 ): 483 - 485 .
Kong H Y . Clinical observation on the adjuvant treatment of mild acute pancreatitis with Dachaihu decoction and mirabilite external application [J]. J Pract Tradit Chin Med , 2026 , 42 ( 3 ): 483 - 485 . (in Chinese)
张淑芹 , 孙海英 . 肠道营养干预对失代偿性肝硬化患者营养状况及肝功能的影响 [J]. 中华肝脏病杂志 , 2013 , 21 ( 10 ): 3 .
Zhang S Q , Sun H Y . The influence of intestinal nutrition intervention on the nutritional status and liver function of patients with decompensated liver cirrhosis [J]. Chinese Journal of Hepatology , 2013 , 21 ( 10 ): 3 . (in Chinese)
蒋颖 , 肖雅 . 加味真武汤口服联合穴位贴敷治疗乙肝肝硬化失代偿期腹水疗效观察 [J]. 现代中西医结合杂志 , 2024 , 33 ( 18 ): 2588 - 2591, 2616 .
Jiang Y , Xiao Y . Observation on therapeutic effect of Jiawei Zhenwu decoction combined with acupoint application on ascites in decompensated stage of hepatitis B cirrhosis [J]. Mod J Integr Tradit Chin West Med , 2024 , 33 ( 18 ): 2588 - 2591, 2616 . (in Chinese)
Zhang Y , Li M , Wang H . Risk factors and nursing strategies for lower limb edema in patients with decompensated liver cirrhosis [J]. J Clin Nurs , 2021 , 30 ( 19-20 ): 2890 - 2897 .
林勇 , 曾欣 , 胡平方 . 中国肝硬化临床诊治共识意见 [J]. 临床肝胆病杂志 , 2023 , 39 ( 9 ): 2057 - 2073 .
Lin Y , Zeng X , Hu P F . Chinese consensus on clinical diagnosis and therapy of liver cirrhosis [J]. J Clin Hepatol , 2023 , 39 ( 9 ): 2057 - 2073 . (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
