胸部多组织弹片贯穿伤的救治与护理  

Treatment and nursing of multi organization bullet perforating injury of breast

作　　者：赵军红 夏磊 马珍珍 ZHAO Junhong;XIA Lei;MA Zhenzhen(Department of Spinal Surgery,the 371st Central Hospital of PLA,Xinxiang 453000,China)

机构地区：[1]解放军371医院脊柱外科,河南新乡453000

出　　处：《西北国防医学杂志》2018年第7期452-455,共4页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨胸部多组织弹片贯穿伤的救治与护理要点。方法:开通紧急救治绿色通道,迅速建立静脉通路,纠正休克,留置胃管进行胃肠减压、留置尿管保持尿路通畅,完善术前检查进行急诊手术,术前严密观察患者的神志、尿量及病情变化,做好心理护理、体位护理及术前准备等;术后密切观察患者的神志、呼吸、生命体征及病情变化,给予合理的体位护理、疼痛护理、管道护理、饮食护理、呼吸道管理等,病情平稳后进行二次手术,在做好围术期护理的同时,积极观察患者神经系统功能的恢复情况,针对患者双下肢肌力制定综合的康复功能训练,预防术后并发症的发生,促进患者双下肢感觉运动功能的恢复,总结救治要点及护理体会。结果:术后患者病情稳定,恢复良好,双下肢肌力4+级,在辅助下可站立行走,大、小便正常。结论:胸部多组织弹片贯穿伤的救治,在做好紧急现场救护的同时,需在最短的时间内送至医院进行抗休克治疗并迅速实施手术,这是成功救治的关键。术后做好病情观察与护理,维持有效的血液循环和水电解质平衡,促进神经功能的恢复是提高治愈率的重要保障。Objective：To discuss the treatment and nursing about multi organization bullet perforating injury of breast.Methods：By opening the green channel for emergency treatment,establishing the venous access rapidly,rectifying the state of shock,indwelling gastric tube for gastrointestinal decompression,indwelling urethral catheterization to keep the urinary tract unobstructed,completing the preoperative examination for emergency operation,doing close observation of the patient′s consciousness,urine volume and condition changes before operation and insuring psychological nursing,position nursing and preoperative preparation,etc.The patient′s consciousness,breathing,vital signs and changes of illness were closely observed,reasonable posture nursing,pain nursing,pipeline nursing,diet nursing,respiratorytract management and so on were given.Then the second operation was did after a stable condition,the perioperative nursing was made,and the recovery of the function of the nervous system at the same time was observed.By studying the muscle strength of the lower,the comprehensive rehabilitation function training was made to prevent postoperative complications and promote the recovery of sensory motor function of the lower limbs.Finally the main points of treatment and nursing experience were summarized.Results：The patient′s condition was stable and recovered well after operation.The strength of the lower extremities was 4＋,and the patients could stand and walk under the 1 assistance.Conclusion：Through the practice and experience,the treatment of multiple tissue bullet perforating injury of brest is to be delivered to the hospital in the shortest time,and the operation should be carried out quickly is the key to the treatment successful.It is an important guarantee to improve the cure rate by observing and nursing the patient′s condition after operation,maintaining the effective blood circulation and balance of water and electrolytes,recovery of the nerve function as well.

关 键 词：胸部 多组织 弹片贯穿伤 救治与护理 

分 类 号：R605.97[医药卫生—急诊医学]