重症肌无力胸腺扩大切除术后患者再次气管插管的原因分析及护理  

The reason analysis and nursing of endotracheal intubation again in patients with myasthenia gravis after thymus expanded resection

作　　者：陈莉[1] 

机构地区：[1]广州中医药大学第一附属医院心胸血管外科,广东广州510405

出　　处：《世界最新医学信息文摘》2014年第27期20-21,共2页World Latest Medicine Information Electronic Version

摘　　要：目的：探讨重症肌无力胸腺扩大切除术后患者再次气管插管的原因及护理对策。方法回顾性分析2008年8月至2013年2月施行胸腺切除术后再次气管插管的12例病例资料。结果11例存活，1例死亡，病死率为8%。术后并发肌无力危象、呼吸衰竭、肺部感染是再次气管插管的主要原因。结论挽救患者生命的一个关键措施就是及时进行再次插管，这也会对预后效果产生直接影响。只有做好充分的术前准备，对患者进行正确评估，加强对高危病人的监护，对拔管适应证进行严格的把握，对术后镇痛加以重视，对突发事件进行积极的预防，这样才能有效减少再插管次数，使病死率有所降低，促进病人的身体康复。Objective to investigate the causes of endotracheal intubation again in patients with myasthenia gravis after thymus expanded resection and its nursing strategy.Methods the data of 12 cases with endotracheal intubation again after thymectomy were retrospectively analyzed from August 2008 to February 2013. Results 11 cases survived and 1 case died, with the mortality rate 8%. the main reasons for endotracheal intubation once more were postoperative myasthenia gravis crisis, respiratory failure and pulmonary infection. Conclusion one of the key measures to save the lives of patients is timely re intubation, which will have a direct impact on the prognosis. only adequate preoperative preparation, proper assessment for the patients, intensive care for high risk patients, strictly grasping the indications of extubation, paying attention to postoperative analgesia and the prevention of emergencies could effectively reduce reintubation times, decrease the mortality rate and promote physical rehabilitation of patients.

关 键 词：重症肌无力 术后 再次气管插管 原因 护理 

分 类 号：R[医药卫生]