总结1例炎症性肠病肠穿孔术后造口旁瘘合并凝血功能异常患儿的护理经验。护理要点包括基于病情及药物敏感试验的阶梯式抗感染管理与感染监测；基于湿性愈合理论进行造口旁瘘伴多发潜行及窦道的护理干预；积极纠正凝血功能异常，严格大剂量输血的护理管理；制订个性化营养支持方案，保障长期禁食患儿的营养支持；基于应激适应理论，采用评估-干预-支持三位一体模式，助力患儿疼痛管理；全周期心理护理，预防患儿创伤后应激障碍。该案例为儿童炎症性肠病合并凝血功能异常及复杂造口并发症的系统化护理提供了实践经验，其关键护理经验在于多学科协作、个体化全程管理、系统化应对复杂并发症。经过医护团队146 d的精心治疗与护理，患儿康复出院。

The nursing experience of a child with parastomal fistula complicated by coagulopathy following intestinal perforation due to inflammatory bowel disease (IBD) were summarized.Key nursing points included: stepwise anti-infection management and monitoring based on the patient’s condition and drug sensitivity tests; nursing interventions for parastomal fistula with multiple sinuses based on the theory of moist wound healing; active correction of coagulopathy and strict nursing management of high-dose blood transfusion;development of an individualized nutritional support plan to ensure adequate nutrition for the child during long-term fasting; implementation of an “Assessment-Intervention-Support” trinity model based on stress adaptation theory to facilitate effective pain management; whole-cycle psychological care to prevent post-traumatic stress disorder (PTSD).This case provides practical experience for the systematic nursing of pediatric IBD patients with coagulopathy and complex stoma complications.The critical nursing experience lies in multidisciplinary collaboration,individualized full-cycle management,and systematic response to complex complications.After 146 days of meticulous treatment and nursing care by the medical team,the child recovered and was discharged.

R473.72