27例A型主动脉夹层重度肥胖患者围手术期呼吸道的护理  

Perioperative respiratory care in 27 severely obese patients with type A aortic dissection

作　　者：陶建 雷黎明 宋亚敏 TAO Jian;LEI Liming;SONG Yamin

机构地区：[1]南方医科大学附属广东省人民医院(广东省医学科学院)广东省心血管病研究所心外重症监护科,广州市510080

出　　处：《中华护理杂志》2024年第15期1895-1899,共5页Chinese Journal of Nursing

摘　　要：总结27例急性A型主动脉夹层重度肥胖患者围手术期呼吸道的护理经验。护理要点如下。术前积极干预肥胖低通气综合征及阻塞性睡眠呼吸暂停综合征;避免胸腹内压急剧升高。术中做好困难气道的管理及急救护理配合;落实集束化肺功能保护措施。术后优化体位管理;实施肺膈肌保护策略;采用渐进式降级脱机疗法,增强呼吸肌耐力;加强肺部感染的监控;开展早期康复及心理疏导。经过精心治疗与护理,26例痊愈出院,1例脱机困难予气管切开并转入呼吸康复医院。To summarize the perioperative nursing of respiratory care in 27 severely obese patients with acute type A aortic dissection.The mainly nursing points are as follows:active intervention for obesity hypoventilation syndrome and obstructive sleep apnea syndrome were conducted preoperatively,and a transient increase in intrathoracic and abdominal pressure were avoided.Intraoperative emergency care coordination for difficult airway was enhanced,and intensive lung function protection measures were implemented.Postoperative postural management was optimized;lung diaphragm protective strategies were carried out;progressive invasive-non-invasive step-down therapy was conducted to enhance ventilator endurance;lung infection surveillance was strengthened;early rehabilitation and psychological counselling were implemented.After careful treatment and nursing care,26 cases were cured and discharged from the hospital,and a case with difficulty in extrication was transferred to the respiratory rehabilitation hospital under tracheotomy.

关 键 词：主动脉夹层 肥胖 呼吸道 低氧血症 围手术期护理 

分 类 号：R473.5[医药卫生—护理学]