肺泡蛋白沉着症大容量全肺灌洗治疗的护理

Nursing of patients with pulmonary alveolar proteinosis treated by whole lung lavage

大容量全肺灌洗是目前治疗肺泡蛋白沉着症唯一有效的方法。总结了17例肺泡蛋白沉着症患者,经43侧次大容量全肺灌洗治疗的护理要点:术前做好患者准备、物品准备及心理护理;术中严密观察生命体征及动脉血氧分压、经皮血氧饱和度改变,防止灌洗液溢漏入对侧肺,注意灌洗压力与引流速度,应用变换体位与胸部叩击法促进沉着蛋白随灌洗液排出;术后行呼气末正压通气并吸尽残存灌洗液,鼓励行有效咳嗽,给予吸氧,应用激素、抗生素防止肺部感染等。灌洗后17例患者呼吸困难、低氧血症等情况明显改善。

Whole lung lavage is the only effective way for the treatment of pulmonary alveolar proteinosis. In the paper, we summarized our key points in caring 17 patients with pulmonary alveolar proteinosis undergoing whole lung lavage for 43 times, including good preparation of patients and stuff and mental care before lavage, close observation of vital signs, arterial partial pressure of oxygen and arterial pulse saturation of blood oxygen, prevention of lavage leakage into opposite lung, stress on lavage pressure and drainage speed, use of bodily posture and chest-knocking to facilitate expulsion of the douche during lavage, and performance of positive end expiratory pressure and complete drainage of remained douche, encouragement of effective cough, inhalation of oxygen, use of hormone and antibiotic to prevent infection after lavage. By lavage, the symptoms of anhelation and hypoxemia were eliminated in 17 cases.