肌萎缩侧索硬化症患者9例行经皮内镜胃造瘘术的护理研究  

Research on the nursing of 9 patients with amyotrophic lateral sclerosis undergoing percutaneous endoscopic gastrostomy

作　　者：黄温馨 王敏秀[1] HUANG Wenxin;WANG Minxiu(Department of Neurology,Union Hospital Affiliated to Fujian Medical University,Fujian,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院神经内科,福建福州350001

出　　处：《中国医药科学》2021年第9期236-240,共5页China Medicine And Pharmacy

摘　　要：总结9例肌萎缩侧索硬化症患者行经皮内镜胃造瘘术的的护理经验。患者均在术前予神志、呼吸、肌力、营养、心理、约束、躁动-镇静评估。为预防术中使用镇静剂引起的呼吸抑制,减少抢救及缩短手术时间,应根据患者病情予术前气管插管。协助医生在重症监护室内完成经皮胃造瘘术,术后遵循胃造瘘护理常规。术毕应立即评估气管插管患者拔管时机,尽早拔除气管插管。重视患者心理护理,增加医护、病友、家庭、社会支持。3例患者术前予经鼻气管插管,9例患者均顺利行经皮胃造瘘术,手术平均用时(25.33±4.15)min。2例气管插管患者顺利拔除气管插管予无创呼吸机辅助呼吸,9例患者均出院继续家庭疗养。The nursing experience of 9 patients with amyotrophic lateral sclerosis undergoing percutaneous endoscopic gastrostomy was summarized.All patients were assessed in consciousness,respiration,muscle strength,nutrition,psychology,restraint and agitation-sedation before operation.In order to prevent respiratory depression caused by sedative during operation,reduce rescue and shorten operation time,tracheal intubation before operation should be conducted according to the patient's condition.Patients should assist doctors to complete percutaneous gastrostomy in intensive care unit and follow the conventional nursing of gastrostomy after operation.After operation,the extubation time should be evaluated immediately and the tracheal intubation should be removed as soon as possible.Patients'psychological nursing should be attached importance to,and the support from medical nursing,wardmate,family and society should be increased.3 patients were intubated by nasal trachea before operation,and 9 patients underwent percutaneous gastrostomy successfully.The average operation time was(25.33±4.15)min.2 patients with endotracheal intubation were successfully extubated for noninvasive ventilator assisted breathing,and 9 patients were discharged from hospital to continue home recuperation.

关 键 词：肌萎缩侧索硬化症 经皮内镜胃造瘘术 护理 术前评估 

分 类 号：R473.5[医药卫生—护理学]