108例全身麻醉留置双腔气管插管患者麻醉恢复期的护理

Nursing care of 108 patients with double-lumen endotracheal tubes in post anesthesia care unit

报告了108例麻醉恢复室(PACU)全身麻醉术后留置双腔支气管导管患者的护理。15例保留双腔支气管导管期间发生低氧血症,其中5例发生在机械通气情况下,自主呼吸的患者中6例双腔管退至气管,3例纠正、3例重新用呼吸机辅助呼吸纠正,4例双腔气管插管移位、换单腔管。108例中19例发生不同程度低钠、低钾、低钙。以上情况均被及时发现和处理,患者安全送返病房。认为应密切观察全身麻醉术后双腔支气管导管位置,正确设置呼吸机参数,保持呼吸道通畅,观察通气量,监测血氧饱和度、心率、血压、动脉血氧、电解质情况,确保患者安全度过麻醉苏醒期。

This paper reports nursing care of 108 patients with double-lumen endotraeheal tubes（DLT） in post anesthesia care unit （PACU）. Hypoxemia occurred in 15 patients,among which,5 patients under mechanical ventilation and 10 patients with spontaneous breathing. After withdrawing the DLT into the main trachea in 6 patients with spontaneous breathing,hypoxemia was relieved in 3 patients,and the other 3 patients had to resume mechanical ventilation. DLT displacement occurred in 4 patients with spontaneous breathing,and was replaced by single-lumen endotracheal tubes. Hyponatremia,hypokalemia or hypocalcemia occurred in 19 patients,which were treated promptly and delivered to the wards safely. In order to ensure patient safety in emergencing phase,it is emphasized that close attention should be paid to the location of DLT,proper parameters set for mechanical ventilation,maintaining airway open,observation of ventilation volume,close monitoring of blood oxygen saturation, heart rate,blood pressure,and plasma electrolytes