双腔气管插管围麻醉期的护理配合

Cooperation in Nursing with Anesthesia for Double Lumen Endobronchial Tube

双腔管插管麻醉为胸科手术的开展提供了便利条件。但双腔管插管麻醉下实施开胸手术涉及单肺通气、体位变化及呼吸循环生理的改变,对患者生理状态影响显著,因此对围麻醉期护理配合有更高的要求。护士应加强术前访视,正确准备麻醉物品和合适的双腔气管导管;积极配合麻醉医师进行支气管插管、定位与固定;并在体位变化和手术过程中加强观察,避免双腔气管导管移位;麻醉维持期和苏醒期协助密切监测呼吸功能,保持气道通畅;配合正确拔管,避免低氧血症和复张性肺水肿等并发症发生,确保手术和麻醉的护理安全。

Anesthesia via double lumen endobronchial tube facilitates thoracic operations. However, since the procedure involves one-lung ventilation, posture shift and physiological changes in patient＇s respiration, it can massively influence his condition. It thus calls for better cooperation in the nursing of the patient during anesthesia. Nurses should achieve the following standards： increased preoperative visits, proper preparation of anesthesia instruments, medicine, and suitable tubes; active cooperation with anesthetists to insert, localize and fix the tubes; strengthened observation during posture shifts and operation so as to avoid dislocation of the tubes; close surveillance on the patient＇s respiration during maintenance of and resuscitation from anesthesia so as to keep a clear airway; and facilitation of correct extubation in case of complications such as hypoxemia and reexpansion pulmonary edema.