1例胸腔镜联合颈胸入路左肺上沟瘤切除伴锁骨下动脉置换术护理配合  

Nursing cooperation during a case of left superior lung sulci tumor excision through cervicothoracic approach assisted by thoracoscope and subclavian artery replacement

作　　者：孙香美 钱晨[1] 刘静[1] 丁洪瑞 吴荻 季弯弯 崔萌 Sun Xiangmei;Qian Chen;Liu Jing;Ding Hongrui;Wu Di;Ji Wanwan;Cui Meng(Jiangsu provincial tumor hospital,Nanjing,Jiangsu,210009,China)

机构地区：[1]南京医科大学附属肿瘤医院、江苏省肿瘤防治研究所、江苏省肿瘤医院,210009

出　　处：《齐齐哈尔医学院学报》2023年第2期192-196,共5页Journal of Qiqihar Medical University

摘　　要：回顾总结1例胸腔镜联合颈胸入路左肺上沟瘤切除伴锁骨下动脉置换术患者的手术护理配合。术前主要通过术前访视、阅读病案资料及与手术医生沟通后,充分做好了患者的护理评估、物品的准备尤其是人工血管的制备、人力资源的准备、以及术前静脉通路的选择、压力性损伤和深静脉脉血栓发生风险的评估和预防措施的落实,为患者做好了充分的术前准备;术中如何做好锁骨下动脉热缺血的管理、人造血管置换的护理配合、以及乳糜漏的观察等护理措施的落实,保证了手术的顺利完成;术后患侧肢体的观察和护理、管路安全的严格落实和患者的转运交接护理措施的落实,使患者安全的返回病房。该手术的成功充分体现了巡回护士统筹、协调能力和洗手护士术中的应急能力,为同类手术积累了较多的手术护理经验。To retrospectively summarize the operative nursing cooperation of a patient who underwent thoracoscopic left superior sulcus tumor resection through cervicothoracic approach and subclavian artery replacement.After preoperative visits,reading medical records and communicating with the surgeons,we fully made nursing assessment for patients and preparation of items,especially the preparation of artificial blood vessels,preparation of human resources,and the selection of preoperative venous access,the implementation of preventive measures such as pressure injury and deep vein thrombosis risk assessment.In short,adequate preoperative preparation was made for the patients.The implementation of nursing measures such as the management of heat ischemia of subclavian artery and the nursing cooperation of artificial blood vessel replacement,the observation of chylous leakage ensures the smooth completion of the operation.Postoperative observation and nursing of the affected limb,strict implementation of pipeline safety and implementation of nursing measures for patient transfer and handover,so that patient can return safely ward.The success of the operation fully reflects the overall planning and coordination ability of the itinerant nurse and the emergency ability of the hand-washing nurse during the operation,and has accumulated a lot of surgical nursing experience for similar operation.

关 键 词：肺上沟瘤 人工血管置换 锁骨下动脉 护理配合 热缺血管理 

分 类 号：R655[医药卫生—外科学]