1例ECMO支持下袖式左全肺切除术患者的护理  

Perioperative nursing care of a patient undergoing sleeve left total pulmonary resection under extracorporeal membrane oxygenation support

作　　者：张馨元 樊榕榕[1] 吴文芳 魏姣 李浩[1] Zhang Xinyuan;Fan Rongrong;Wu Wenfang;Wei Jiao;Li Hao(Department of Thoracic Surgery,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院胸外科,北京100044

出　　处：《护理学杂志》2024年第20期60-63,共4页Journal of Nursing Science

摘　　要：总结1例体外膜肺氧合支持下行左侧胸腔镜联合右侧开胸袖式左全肺切除术患者的围手术期护理经验。术前护理包括:指导呼吸功能锻炼,积极控制感染;实施预见性护理,预防术后并发症。术后护理包括:全面评估呼吸系统风险,实施针对性气道管理;严格安全体位管理,预防气管吻合口愈合不良;平衡术后出入量,预防心肺并发症;多维度管理疼痛,制订并实施个性化康复锻炼方案;关注凝血功能,预防出血、血栓并发症;积极控制感染,促进手术切口愈合;关注喉返神经损伤及康复情况,改善长期生活质量。经围术期密切护理,患者恢复顺利,于术后第8天出院,术后3个月随访,患者康复良好。The perioperative nursing experience of a patient who underwent thoracoscopy combined with right thoracotomy sleeve style left total pulmonary resection under extracorporeal membrane oxygenation support was summarized.Preoperative nursing included guidance of respiratory functional exercise and actively control of infections,assessment of potential postoperative complications and implementation of predictive care.Postoperative nursing included comprehensive assessment of respiratory system risks,personalized implementation of airway management,management of safe position to prevent poor healing of tracheal anastomosis,balancing postoperative inflow and outflow to prevent cardiovascular complications,multidimensional pain management,persona-lized development and implementation of rehabilitation exercise plans,paying attention to coagulation function and preventing complications such as bleeding and thrombosis,control of infection,promoting surgical incision healing,paying attention to recurrent laryngeal nerve injury and rehabilitation to improve long-term quality of life.After intensive perioperative care,the patient recovered smoothly and was discharged on the 8th day after surgery.After 3 months of follow-up,the patient′s recovery was good.

关 键 词：气管肿瘤 气管支气管腺样囊性癌 肺不张 袖式全肺切除 胸腔镜手术 气管切除重建术 体外膜肺氧合 护理 

分 类 号：R473.6[医药卫生—护理学]