18例心脏穿透伤患者的急救与护理

目的通过18例心脏穿透伤患者的手术抢救与护理,总结心脏穿透伤患者急救与护理要点。方法所有患者均实施心壁裂开修补、心包开窗引流术,采取相应的护理措施,包括术前加强循环系统及呼吸系统的急救护理,术后监测生命指征、尿量,保护脑细胞,加强呼吸系统及引流管的管理,严防并发症。结果18例患者抢救成功15例,3例抢救无效死亡,抢救成功率83.3%。本组病例无1例出现出血、休克、感染等并发症。结论严密观察病情变化,加强术后各项护理措施,特别是各种引流管的观察及护理,预防并发症的发生,是心脏穿透伤患者救治成功的关键。

Objective To summarize the main points of first aid and nursing for heart pierced patients. Methods All patients had mended heart crack, opened pericardia through drainage operation and actualized personalized nursing measures, including strengthening first aid nursing to circulation system and respiratory system before operation, monitoring vital signs and urine volume after operation, protecting brain cells, strengthening the management of respiratory system and drainage tube and avoiding complications. Results Fifteen out of 18 had been cured. None of them had complications such as bleeding, shock and infection. Conclusions The key factors for successful salvage include the following: to monitor patient's condition closely, to strengthen postoperative nursing measures, especially to observe and care all kinds of drainage tubes and to avoid complications.