摘要
目的 探讨泛发性脓疱型银屑病合并碳青霉烯类耐药菌感染患者的皮肤护理及耐药菌防控护理策略及效果。方法 针对1例GPP合并头部葡萄球菌耐药患者，在做好皮肤专科护理的基础上，围绕皮肤完整性损伤有感染风险及耐药菌传播风险，实施多维度防控护理干预，包括皮肤屏障修复及护理、外用药物护理、隔离管理、无菌操作强化、三级督导机制、多学科协作、健康宣教及心理护理等。结果 护理有效，无交叉感染和继发感染发生。结论：精准化皮肤护理及耐药菌防控护理可有效降低感染风险，为GPP合并耐药菌患者的治疗安全提供保障。
关键词： 脓疱型银屑病；多重耐药菌感染；个案护理
Abstract
Objective To investigate the skin care strategies and antimicrobial resistance prevention measures for patients with generalized pustular psoriasis (GPP) complicated by carbapenem-resistant bacteria (CRB). Methods A case of GPP with Staphylococcus aureus resistance was treated through multidimensional nursing interventions. These included skin barrier repair, topical medication management, isolation protocols, enhanced aseptic techniques, a three-tier supervision system, multidisciplinary collaboration, health education, and psychological support. Results The interventions proved effective, with no cross-infections or secondary infections occurring. Conclusion Precise skin care and CRB prevention strategies can significantly reduce infection risks, ensuring safe treatment for GPP patients with antimicrobial resistance.
Key words： Pustular psoriasis; Multidrug-resistant bacteria infection; Case nursing
参考文献 References
[1] 《脓疱型银屑病诊疗中国专家共识(2022 版)》编写委员会专家组.脓疱型银屑病诊疗中国专家共识(2022 版)[J]中华皮肤科杂志2022,55(3):187-195.
[2] 张浩,泛发性脓疱性银屑病发病机制及生物制剂治疗进展,[J].中国医学前沿杂志2023 ,15 (5):76.
[3] PRINZ JC,CHOON SE,GRIFFITHS CEM,et al.Prevalence, comorbidities and mortality of generalized pustular psoriasis:A literature review [J].J Eur Acad Dermatol Venereol,2023,37(2):256-273.
[4] 侯媛,陈晓霞,王柄璋等住院病人多重耐药菌感染控制管理风险预警指标体系的构建,[J].护理研究 2024, 38(10). 1693-1701.
[5] 谢秀璋,4R危机管理对多重耐药菌感染防控措施落实情况及感染发生率的影响,[J].中华养生保健第 2024, 42(17) 89-92.
[6] 王静,综合 ICU 多重耐药菌感染的分析与护理干预效果,[J]中国实用医药2018.13(6)196-197.
[7] 王少明、亓广伟烧烫伤患者多重耐药菌感染情况及药敏分析,[J]中国实用医药2023.18(20)81-84.
[8] 张肖莹 李柏樟 方卉等天疱疮患者皮肤多重耐药菌感染两种预测模型的构建及验证,[J]中华急危重症护理杂志 2024,5 (10)882-888.
[9] 张凤琴 侯珂君 龙靖等,分级管理模式在多重耐药菌医院感染防控中的效果,[J]中国卫生标准管理 2024, 15(23):173-175+186.