老年急性脑卒中患者显性误吸致呼吸衰竭的护理  

Inspection and Nursing of Respiratory Failure Induced by Dominant Aspiration in Stoke Patients

作　　者：周玲善 张弢 郭振辉[3] 胡映霞[4] 莫泽珣[3] 

机构地区：[1]解放军458医院ICU,广东广州510602 [2]解放军458医院医务处,广东广州510602 [3]广州军区广州总医院老年重症医学科 [4]广东省第二人民医院神经外科

出　　处：《华南国防医学杂志》2014年第12期1248-1250,共3页Military Medical Journal of South China

基　　金：全军医药卫生科研项目重点专项(10BJZ09);广州科技计划项目(2014J4100033)

摘　　要：目的观察老年急性脑卒中患者显性误吸致呼吸衰竭的特征,探讨其临床救治与护理。方法回顾总结37例急性脑卒中并显性误吸致呼吸衰竭患者,临床处理包括清除呼吸道吸入物、维护呼吸功能、预防再误吸等临床救治与护理措施;同时,监护心功能与呼吸功能变化与病情进展。结果本组37例多为有多种基础疾病的老年患者,其显性误吸后均出现Ⅰ型呼吸衰竭,其中29例为并发急性心功能衰竭,死亡3例另8例发展为ARDS,死亡5例。结论老年急性脑卒中患者发生显性误吸时极易发生呼吸衰竭,而急性心功能衰竭和ARDS是导致Ⅰ型呼吸衰竭的二大原因,其中,ARDS患者预后差;及时发现显性误吸、有效清除吸入物与呼吸支持,是老年急性脑卒中患者发生显性误吸时最关键的救治与护理。同时,有效的监护、预防再误吸有助于老年急性脑卒中患者呼吸衰竭的进展和预后的改善。Objective To observe the clinical features of respiratory failure induced by dominant aspiration in elderly acute cerebral stroke（ACS）patients and explore appropriate first aids.Methods A retrospective study was performed on 37 ACS patients with respiratory failure induced by dominant aspiration.Clinical treatments included airway clearance,respiratory function maintaining and re-aspiration prevention were taken.Surveillance of cardiac and respiratory functions was also performed.Results Among the 37 cases,3 cases died in 29 ACS patients concomitant with acute heart failure while 5 cases died in the other 8 ACS patients concomitant with ARDS.Conclusion ACS patients with dominant aspiration are susceptible to acute heart failure and ARDS and most of them may result in a poor outcome.Prompt detection,effective airway clearance and respiratory function maintaining are beneficial to patients’ effective cure and improving outcomes.

关 键 词：急性脑卒中 误吸 呼吸衰竭 护理 

分 类 号：R470[医药卫生—护理学]