先天性心脏病术后并发膈肌麻痹的护理  

Nursing care of children developing diaphragmatic paralysis after correction surgeries for congenital heart diseases

作　　者：吴岚[1,2] 廖雪丽[1,2] 杨满青[1,2] 

机构地区：[1]广东省心血管病研究所 [2]广东省人民医院/广东省医学科学院心外科重症监护二区,广东广州510080

出　　处：《护理学杂志》2012年第12期19-21,共3页

基　　金：十二五国家科技支撑计划项目(2011BAI11b22);广东省科技计划项目(2009B030801033)

摘　　要：目的总结先天性心脏病术后膈肌麻痹患儿的护理要点。方法对51例先天性心脏病术后并发膈肌麻痹患儿加强呼吸道管理,防治肺部感染;拔除气管插管后积极应对喉头水肿、支气管痉挛等并发症。结果29例患儿呼吸困难症状轻,术后顺利撤离呼吸机;22例反复撤机失败行膈肌折叠术,其中19例膈肌折叠后顺利撤机痊愈出院,3例死亡。结论先天性心脏病术后撤离呼吸机过程中应密切观察病情变化,及时评估膈肌功能及采取有效的护理措施,对于并发膈肌麻痹患儿的康复至关重要。Objective To summarize nursing care of children developing diaphragmatic paralysis after correction surgeries for congenital heart diseases. Methods A total of 51 children after cardiac surgery developed diaphragmatic paralysis. They were given mechanical ventilation and preventive measures against pulmonary infection. After removal of endotracheal tube, children were closely observed for such complications as laryngeal edema, bronchial spasm, etc. Results Among 51 children, 29 children had mild dyspnea, and were able to wean off ventilation; 22 had diaphragm plication after repeated attempts to wean off ventilation. Among those who had diaphragm plication, 19 cases were able to wean off ventilation and were discharged, while 3 cases died. Conclusion Patients after receiving surgery for congenital heart diseases should be observed closely during ventilation weaning. It is important to timely assess the diaphragmatic function of patients and take effective nursing measure for those developing diaphragmatic paralysis after cardiac surgery.

关 键 词：心脏缺损 先天性心脏病 呼吸困难 膈肌麻痹 膈肌折叠术 护理 

分 类 号：R473.6[医药卫生—护理学]