27例A型主动脉夹层重度肥胖患者围手术期呼吸道的护理
Perioperative respiratory care in 27 severely obese patients with type A aortic dissection
陶建 1雷黎明 1宋亚敏1
作者信息
- 1. 510080 广州市 南方医科大学附属广东省人民医院(广东省医学科学院)广东省心血管病研究所心外重症监护科
- 折叠
摘要
总结27例急性A型主动脉夹层重度肥胖患者围手术期呼吸道的护理经验.护理要点如下.术前积极干预肥胖低通气综合征及阻塞性睡眠呼吸暂停综合征;避免胸腹内压急剧升高.术中做好困难气道的管理及急救护理配合;落实集束化肺功能保护措施.术后优化体位管理;实施肺膈肌保护策略;采用渐进式降级脱机疗法,增强呼吸肌耐力;加强肺部感染的监控;开展早期康复及心理疏导.经过精心治疗与护理,26例痊愈出院,1例脱机困难予气管切开并转入呼吸康复医院.
Abstract
To summarize the perioperative nursing of respiratory care in 27 severely obese patients with acute type A aortic dissection.The mainly nursing points are as follows:active intervention for obesity hypoventilation syndrome and obstructive sleep apnea syndrome were conducted preoperatively,and a transient increase in intrathoracic and abdominal pressure were avoided.Intraoperative emergency care coordination for difficult airway was enhanced,and intensive lung function protection measures were implemented.Postoperative postural management was optimized;lung diaphragm protective strategies were carried out;progressive invasive-non-invasive step-down therapy was conducted to enhance ventilator endurance;lung infection surveillance was strengthened;early rehabilitation and psychological counselling were implemented.After careful treatment and nursing care,26 cases were cured and discharged from the hospital,and a case with difficulty in extrication was transferred to the respiratory rehabilitation hospital under tracheotomy.
关键词
主动脉夹层/肥胖/呼吸道/低氧血症/围手术期护理Key words
Aortic Dissection/Obesity/Airway/Hypoxemia/Perioperative Nursing引用本文复制引用
出版年
2024
NETL
NSTL
万方数据