总结1例重症急性胰腺炎（severe acute pancreatitis,SAP）合并重度肺外急性呼吸窘迫综合征（acute respiratory distress syndrome,ARDS）患者行体外膜肺氧合治疗（extracorporeal membrane oxygenation,ECMO）的护理经验。护理要点包括：在严密呼吸力学监测下实施超保护性肺通气策略、进行ARDS液体分期管理、严格控制与管理腹内高压、积极解决现有感染源并预防新发感染、基于出凝血平衡动态实施ECMO期间个体化抗凝的预见性护理、结合SAP病理特征强化血糖波动监控与胰岛素滴定化管理、早期开展ICU导向性康复训练。经过24 d的针对性治疗和精细化护理，患者病情好转，成功转至普通病房。

The nursing experience of a patient with severe acute pancreatitis (SAP) complicated with severe extrapulmonary acute respiratory distress syndrome (ARDS) who received extracorporeal membrane oxygenation (ECMO) treatment was summerized.Key points of nursing included:implementing ultra-protective lung ventilation strategies under strict respiratory mechanics monitoring;implementing fluid management for ARDS using the ROSE protocol;strictly controlling and managing intra-abdominal hypertension;actively addressing existing infection sources and preventing new infections;providing predictive nursing for individualized anticoagulation during ECMO based on dynamic balance of coagulation and fibrinolysis;strengthening blood glucose fluctuation monitoring and insulin titration management in line with the pathological characteristics of SAP;and initiating ICU-oriented rehabilitation training early.After 24 days of targeted treatment and meticulous care,the patient’s condition improved and was transferred to a general ward.

R473.5

广州市卫生健康科技一般引导项目（20251A011080）