论文：胸腔镜治疗巨大肺大疱围手术期护理,论文

时间 : 2009-12-06 21:08:25 来源：www.govyi.com

[摘要]

胸腔镜治疗巨大肺大疱围手术期护理，

作者：刘海燕，申丽君，谭亚蒲，李明

【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

【Abstract】ObjectiveToexploretheperioperativenursingofhugepulmonarybullatreatedbyvideo-assistedthoracicsurgery（VATS）.MethodsNinecasesofhugepulmonarybullatreatedbyVATSwereanalyzedretrospectively.Thepulmonarybullawereallbeyondfiftypercentofthevolumeofonesidepleuralcavity.Beforeoperation,thegradefourofdyspneainfourcases,thegradefivedyspneainfivecasesoccured.Complementaryairwaypreparationandpsychologicnursingbeforeoperation.Assistingsurgeoninoperation,observingillness,preventingthecomplications,nursingtheclosedrainingofpleuralcavityandtrainingpulmonaryfunctionafteroperationwereperformed.ResultsAmongtheninecases,sevencasesaccomplishedpulmonarybullaectomysimplybyVATS,theotherfourcasesneedadditionalminimalincision.Operativetimerangedfrom90to300minutes.Bloodlosswere50～300ml.Endermicemphysemaoccuredafteroperationin2cases.Afteroperation,theconditionofpulmonaryfunctionimproved,dyspneawerecatabatic,theguidelineofdyspnearaised1gradesin5casesand2gradesin4cases.ConclusionThetherapyofhugepulmonaryVATSissafeandfeasible.Theperioperativenursingcanpreventthecomplicationseffectively.

【Keywords】pulmonarybulla;thoracoscopy;perioperativeperiodnursing

电视胸腔镜手术（VATS）是现代胸腔镜技术与先进的医疗器械完美结合的产物。术中医生利用胸腔镜为病人实施手术，大大提高了手术质量，切口小、出血少、损伤轻、并发症少、术后恢复快且美观不留瘢痕，改变了过去人们对胸科手术损伤大，危险性高的恐惧心理。我院2004年3

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