原位肝移植术后的呼吸道管理

Respiratory tract care after orthotopic liver transplantation

目的探讨肝移植术后呼吸道的管理措施。方法回顾分析2001年2月～2007年3月在我院行肝移植术60例患者的病历资料,总结呼吸道管理措施的有效性。结果60例患者中发生术后肺部胸腔积液52例,感染27例,肺不张4例。全部病人实施严格呼吸道保护和保持呼吸道通畅措施。除1例患者术后31天死于术后多器官衰竭外,其余均顺利度过围手术期。结论术后呼吸道管理非常重要,关键要做好严密保护性隔离,重视物理性预防及使用呼吸装置的护理,严格遵守吸痰方法及无菌操作原则,使患者能顺利度过围手术期。

Objective To investigate the respiratory tract care after liver transplantation. Methods From February 2001 to March 2007, the clinical data of 60 cases received liver transplantation were analyzed retrospectively. Results In the 60 cases, plural effusion,pulmonary infection and atelectasis were found after operation in 52,27 and 4 cases respectively.Strict respiratory tract care and keeping fluent respiratory tract were performed in all cases.59 cases were unevenfully to pass perioperative period, only 1 case died of MODS on 3 lth day after operation. Conclusion Adequate respiratory tract is very important for the recovery of liver transplantation.For the patients can smoothly pass perioperative period, it is the key points to strict protective isolation,attending to physical prevention, nursing care of using respiratory apparatus, grasping correct method of aspirated sputum and following principle of aseptic manipulation.