摘要
文章总结了1例肺腺癌患者免疫检查点抑制剂治疗后并发心肌炎、脑梗死及重度血小板减少的护理经验。护理要点包括：构建多学科整合照护团队，实施动态风险评估与预警；落实心肌炎急救与精细化监护，涵盖血流动力学管理与大剂量激素用药护理；快速启动脑卒中绿色通道，强化神经功能保护；动态平衡抗凝治疗与出血风险，实施个体化抗栓管理；分阶段开展早期康复与营养支持；提供全程心理疏导。经过46天多学科协作治疗与护理，患者病情稳定出院，随访1个月，一般情况良好。对于接受免疫治疗并出现多系统、高风险并发症的肿瘤患者，实施以多学科团队为基础的整合护理是保障安全、改善预后的关键。
关键词： 肺腺癌；免疫检查点抑制剂；免疫性心肌炎；特鲁索综合征；急性缺血性脑梗死；血小板减少；多学科协作护理
Abstract
This article summarizes the nursing experience of a patient with lung adenocarcinoma who developed myocarditis, cerebral infarction, and severe thrombocytopenia after immune checkpoint inhibitor therapy. Key nursing points included: establishing a multidisciplinary integrated care team and implementing dynamic risk assessment and early warning; implementing emergency treatment and meticulous monitoring for myocarditis, covering hemodynamic management and high-dose hormone medication care; rapidly activating the stroke green channel and strengthening neurological function protection; dynamically balancing anticoagulation therapy and bleeding risk, and implementing individualized antithrombotic management; conducting early rehabilitation and nutritional support in stages; and providing comprehensive psychological counseling. After 46 days of multidisciplinary collaborative treatment and nursing care, the patient's condition stabilized and was discharged. One month of follow-up showed good general condition. For cancer patients receiving immunotherapy who develop multi-system, high-risk complications, integrated nursing care based on a multidisciplinary team is crucial for ensuring safety and improving prognosis.
Key words： Lung adenocarcinoma; Immune checkpoint inhibitors; Immune myocarditis; Trusso syndrome; Acute ischemic stroke; Thrombocytopenia; Multidisciplinary collaborative nursing
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