支气管肺泡灌洗联合肺吹气治疗开胸术后肺不张的围术期护理

Perioperative nursing of patients with post-thoracotomy atelectasis treated with bronchoalveolar lavage combined with pulmonary insufflation

目的观察12例支气管肺泡灌洗联合肺吹气治疗开胸术后肺不张患者的治疗效果和总结护理要点。方法完善术前准备,做好充分麻醉、心理疏导;术中加强监测,密切配合医生对患者进行支气管肺泡灌洗及肺吹气;加强术后护理。结果12例患者经治疗后均肺复张。与治疗前相比,治疗6 h后的动脉血氧饱和度(arterial oxygen saturation,SaO2)和动脉血氧分压(arterial oxygen partial pressure,PaO2)均显著升高,二氧化碳分压(Co2partial pressure,PaCO2)显著降低,治疗前后比较,差异具有统计学意义(均P<0.05)。治疗中无严重并发症发生,肺不张无复发,患者均顺利出院。结论支气管肺泡灌洗联合肺吹气治疗开胸术后肺不张的效果明显,做好围术期护理对保证支气管肺泡灌洗联合肺吹气治疗顺利完成具有重要作用。

Objective To summarize the perioperative nursing of patients with post-thoracotomy atelectasis treated with bronchoalveolar lavage combined with pulmonary insufflation. Methods Before operation, the nursing measures included the full preoperative preparation, full anesthesia and mental care. During the operation, the nursing focused on intensified monitoring, close cooperation with doctors in manipulation of bronchoalveolar lavage and pulmonary insufflation. After operation, the postoperative nursing was performed. Results The lung recruitments were successful in all the 12 patients. Compared to pre-operation, the arterial oxygen saturation （SaO2） and arterial oxygen partial pressure （Pa02） 6 hours after treatment were significantly improved （P 〈 0.05） while the CO2 partial pressure （PaCO2） was significantly decreased （P 〈 0.05）. There were no severe complications and no recurrence of pulmonary atelectasis. All the patients were successfully discharged. Conclusions The bronchoalveolar lavage combined with pulmonary insufflation is effective in treating post-thoracotomy atelectasis. To ensure the smooth treatment, perioperative nursing is also contributive.