《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (12): 1462-1465.

• 国际会议报道 • 上一篇    下一篇

颈髓损伤患者胸式呼吸重建术围手术期康复护理

贾彦梅,郑红云,车俊艳,李慧兰,李彦君,宋杰
  

  1. 中国康复研究中心北京博爱医院脊柱脊髓神经功能重建科,北京市 100068。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-12-25 发布日期:2015-12-25

Perioperative Rehabilitation Nursing of Thoracic Breathing Reconstruction for Cervical Spinal Cord Injury

JIA Yan-mei, ZHENG Hong-yun, CHE Jun-yan, LI Hui-lan, LI Yan-jun, SONG Jie
  

  1. Department of Spinal and Neural Functional Reconstruction, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-12-25 Online:2015-12-25

摘要: 目的 总结颈髓损伤患者胸式呼吸重建手术围手术期的护理经验,完善护理规范。方法 观察 2013年 3月~2014年 6月本院接受胸式呼吸重建术的颈髓损伤患者6例的护理效果,访视时间从术前1周到术后4周。结果 平均年龄(41.7±16.2)岁;伤后(6.0±5.8) d,因咳痰无力、分泌物多、呼吸困难,给予气管切开;呼吸机使用(45.3±25.9) d,伤后(84±26.7) d接受胸式呼吸重建术;术前肺活量(1085±92) ml,术后2周(1680±283) ml,较术前增加55%(P<0.01)。1例患者因手术切口受压出现切口延迟愈合。术后 4周内,患者均未继发肺部感染、泌尿系感染及压疮。结论 加强气道护理,防止手术切口受压,是降低胸式呼吸重建术后并发症的关键。

关键词: 颈髓损伤, 胸式呼吸重建, 护理, 并发症

Abstract: Objective To summarize experience of nursing for thoracic breathing reconstruction in patients after cervical spinal cord injury (CSCI). Methods 6 cases accepting thoracic breathing reconstruction in our hospital from March 2013 to June 2014 were reviewed from 1 week before operation to 4 weeks after operation. Results All the patients, aged (41.7±16.2) years, received tracheotomy (6.0±5.8) days after injury because of weakened cough, retention of respiratory secretions and dyspnea; the ventilator was used for (45.3±25.9) days, and they received thoracic breathing reconstruction surgery (84±26.7) days after injury. Their vital capacity was (1085±92) ml before operation and was (1680±283) ml 2 weeks after operation with 55% increment (P<0.01). Only 1 patient underwent a delayed wound healing. No pulmonary infection, urinary tract infections and pressure sore occurred until 4 weeks after operation. Conclusion Enhancement of airway care and prevention of pressure sore are the keys to reduce postoperative complications of thoracic breathing reconstruction.

Key words: cervical spinal cord injury, respiratory function reconstruction, nursing, complications