颅脑外伤合并肝挫裂伤急诊手术患儿的麻醉护理1例  

Anesthesia nursing care of a child with craniocerebral injury complicated with liver rupture during emergency operation

作　　者：杨雪婷 蔡静洁 Yang Xueting;Cai Jingjie(Department of Anesthesiology,Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China)

机构地区：[1]上海交通大学医学院附属儿童医院麻醉科,上海200062

出　　处：《加速康复外科杂志》2024年第2期91-95,共5页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

摘　　要：总结1例急诊颅脑外伤导致颅内出血同时伴有严重肝挫裂伤、有肝包膜破裂出血风险患儿的急诊手术麻醉护理经验。麻醉护理要点:麻醉前评估患儿的生命体征、治疗现状;监测凝血功能,关注腹腔脏器损伤,预防并发症发生;强化气管导管护理;配合麻醉诱导,加强液体管理,维持循环血压,中心静脉压稳定,促进围手术期麻醉平稳;关注患儿凝血功能,降低术中肝包膜破裂风险;制定个性化麻醉护理方案,预防低体温,配合医生摆放手术体位。患儿围手术期麻醉平稳,手术顺利,术中未发生血肿破裂出血,术后转回外科监护室继续治疗。Summarize the anesthesia nursing experience of an emergency surgery for a child with intracranial hemorrhage accompanied by traumatic liver rupture and a risk of liver capsule rupture bleeding caused by traumatic brain injury.The anesthesia nursing focus on evaluating the child’s vital signs and treatment status,monitoring coagulation function,paying attention to abdominal organ damage and avoid complications,strengthening the care of tracheal catheters and cooperate with anesthesia induction to strengthen fluid management,maintaining circulating blood pressure and central venous pressure for stable perioperative anesthesia,paying attention to the coagulation function of the pediatric patient and reduce the risk of intraoperative liver capsule rupture.Develop personalized anesthesia care plans,prevent hypothermia,and coordinate with doctors to place surgical positions.The child patient had stable anesthesia during the perioperative period,and the surgery was successful without liver capsule rupture.After surgery,the patient was transferred back to the surgical intensive care unit or further treatment.

关 键 词：颅脑外伤 儿童 肝挫裂 麻醉护理 

分 类 号：R473.6[医药卫生—护理学]