胸腔镜肺减容术治疗重度肺气肿患者围手术期的护理

Nursing of Video-assisted Thoracoscopic Lung Volume Reduction Surgery in the Treatment of Severe Emphysema

目的探讨胸腔镜下肺减容术(LVRS)治疗重度肺气肿的临床疗效及护理。方法做好健康宣教,完善术前检查,改善肺功能,为手术创造良好条件。给予专人护理,并密切监测心肺功能、控制感染,预防并发症发生。结果患者呼吸困难指数由3～4级转为0～2级。术后1s时间肺活量(FEV1)、肺总量(TLC)、残气量(RV)、PaO2、PaCO2和6min步行距离等明显改善,有显著性差异(P<0.01)。结论围手术期积极预防和处理并发症,保证了手术成功,正确的康复指导,提高患者的生活质量、生活自理能力和劳动能力。

Objective To explore the the clinical efficacy and nursing of video--assisted thoracoscopic lung volume reduction surgery（LVRS） for treatment of severe emphysema. Methods It is helpful of health education, special care, close monitoring of cardiorespiratory function and to improve the preoperative examination and lung function, create good condition for surgery, control infection for the prevention and treatment of complications occurence. Results Patients with dysp- nea index from 3--4 to 0--2. After six months of observation and postoperative indicators 1 seconds spirometry（FEV1 ）, lung volume（TLC）, residual volume（RV）, PaCO, and 6 min walk distance improved significantly. Condusion Ir ensure the operation successful, the correct rehabilitation guidance and improve the quality of life, self--care ability and work ability of patients by the perioperative prevention and treatment of complications.