心脏瓣膜置换术后患者呼吸机治疗策略与护理

The mechanical ventilation treatment and nursing in patients after cardiac valve replacement

目的探讨心脏瓣膜置换术后如何通过正确的呼吸机治疗和气道管理，提高术后的成功率。方法通过呼吸参数的设置、机械通气期间的监测和呼吸道管理，及时调节呼吸机参数，掌握吸痰及拔除气管插管的时机及撤机后加强术后管理。结果本组术后机械通气时间为4h至5d，平均15．6±12．4—15．2h。呼吸机相关性肺炎（VAP）发生率为12．3％，死亡6例，其中5例死于低心排出量综合征，1例死于心律失常。结论加强体外循环心内直视手术后患者呼吸机治疗护理是提高手术成功率、减少VAP的重要保证。

Objective To explore the measures of correct mechanical ventilation treatment and artificial airway management in order to improve the surgical success rate. Methods To set and adjust respiratory ventilation parameters and to close monitor the caurse of mechanical ventilation and respiratory management and to master sputum - aspirating opportunity and the time for tube extraction and management after mechanical ventilation withdrawal Results The mechanical ventilation time was 4 h - 5 d, mean 15. 6 ± 12. 4- 15.2 h, the incidence of ventilator- associated pneumonia （VAP） was 12. 3%, 6 cases died, 5 cases died of the low cardiac output syndrome and q ca- ses died of arrhythmia. Conclusions Improved mechanical ventilation treatment and nursing is the important guarantee of increasing the operative successful rate and decreasing VAP.