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胸腔镜治疗巨大肺大疱围手术期护理
http://www.100md.com 《中华现代护理学杂志》 2006年第6期
胸腔镜,,胸腔镜检查;肺大疱;围手术期护理,1临床资料,2围手术期护理,3结果,4讨论,【参考文献】
     【摘要】 目的 探讨电视胸腔镜手术(VATS)治疗巨大肺大疱围手术期护理。方法 对9例(11侧肺叶)临床资料进行回顾性分析。患者肺大疱均占据胸腔>50%,术前呼吸困难4级4例,5级5例。围手术期进行术前呼吸道准备、心理护理,术中密切配合,术后认真观察病情变化、防治并发症、胸腔闭式引流、肺功能训练等。结果 本组9例患者11侧肺叶,其中7侧肺叶在单纯胸腔镜下完成大疱切除,另4侧肺叶在小切口辅助下施行了肺大疱切除。手术时间90~300min,出血50~300ml,术后2例并发皮下气肿。术后肺功能改善,呼吸困难明显缓解,指标提升1级5例,提升2级4例。结论 VATS治疗巨大肺大疱是安全可行的,专科护理技术成熟可有效地预防并发症,促进患者较快康复。

    【关键词】 胸腔镜检查;肺大疱;围手术期护理

    Perioperative nursing for huge pulmonary bulla treated by video assisted thoracic surgery (VATS)

    LIU Haiyan,SHEN Lijun,TAN Yapu,et al.Three Gorges Branch,Gezhouba Central Hospital,Third College of Clinical Medicine,China Three Gorges University,Yichang 443002,China

    【Abstract】 Objective To explore the perioperative nursing of huge pulmonary bulla treated by video-assisted thoracic surgery (VATS).Methods Nine cases of huge pulmonary bulla treated by VATS were analyzed retrospectively.The pulmonary bulla were all beyond fifty percent of the volume of one side pleural cavity.Before operation,the grade four of dyspnea in four cases,the grade five dyspnea in five cases occured.Complementary air way preparation and psychologic nursing before operation.Assisting surgeon in operation,observing illness,preventing the complications,nursing the close draining of pleural cavity and training pulmonary function after operation were performed.Results Among the nine cases,seven cases accomplished pulmonary bullaectomy simply by VATS,the other four cases need additional minimal incision.Operative time ranged from 90 to 300 minutes.Blood loss were 50~300ml.Endermic emphysema occured after operation in 2 cases.After operation,the condition of pulmonary function improved,dyspnea were catabatic,the guide line of dyspnea raised 1 grades in 5 cases and 2 grades in 4 cases.Conclusion The therapy of huge pulmonary VATS is safe and feasible.The perioperative nursing can prevent the complications effectively. ......

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