急性腹膜炎护理个案分析.pptxVIP

急性腹膜炎护理个案分析 目录 健康评估 Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients’ preferences. 。 相关知识 急性腹膜炎是由细菌感染，化学刺激或损伤所引起的外科常见的一种严重疾病。多数是继发性腹膜炎，原于腹腔的脏器感染，坏死穿孔、外伤等。其主要临床表现为腹痛、腹部压痛腹肌紧张，以及恶心，呕吐，发烧，白血球升高，严重时可致血压下降和全身中毒性反应，如未能及时治疗可死于中毒性休克。部分病人可并发盆腔脓肿，肠间脓肿、和膈下脓肿，髂窝脓肿、及粘连性肠梗阻等。 Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients’ preferences. 。 相关知识 腹膜的生理功能： ①润滑作用 ②防御作用 ③吸收作用 ④渗出与修复作用 Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients’ preferences. 。 相关知识 Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients’ preferences. 。 相关知识|分类 1.原发性腹膜炎 原发性腹膜炎临床上较少见，是指腹腔内无原发病灶，病原菌是经由血循、淋巴途径或女性生殖系等而感染腹腔所引起的腹膜炎。多见于体质衰弱，严重肝病患者或在抗病能力低下的情况下，或肾病、猩红热、营养不良并发上呼吸道感染时均可致病，尤其是10岁以下的女孩多见。脓液的性质椐菌种而不同，常见的溶血性链球菌的脓液稀薄而无臭味，脓汁和血培养可找到溶血性链球菌和肺炎双球菌。临床上常有急性腹痛、呕吐、腹泻，并迅速出现脱水或全身中毒症状。 Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients’ preferences. 。 相关知识|分类 2.继发性腹膜炎 继发性腹膜炎是临床上最常见的急性腹膜炎，继发于腹腔内的脏器穿孔，脏器的损伤破裂，炎症和手术污染。主要常见病因有阑尾炎穿孔，胃及十二指肠溃疡急性穿孔，急性胆囊炎透壁性感染或穿孔，伤寒肠穿孔，以及急性胰腺炎，女性生殖器官化脓性炎症或产后感染等含有细菌之渗出液进入腹腔