23例序贯式双肺移植术的围术期护理

Perioperative nursing for 23 patients treated with sequential bilateral lung transplantation

目的总结23例序贯式双肺移植术患者围术期的护理措施。方法术前重视患者教育、心理支持、症状护理及个性化呼吸功能训练,术后加强呼吸系统及循环系统的监测、肠内营养治疗、急性排异反应等并发症的防治护理,出院后进行药物、饮食、生活、自我监测等指导。结果 23例患者均顺利完成手术,术后出现低血容量3例,肺部感染5例,急性排异反应11例,气道狭窄4例。存活19例,死亡4例,19例患者经过积极治疗和精心护理,恢复正常生活,康复出院。结论 肺移植术患者围术期采取相应护理措施能有效缓解患者心理压力,提高治疗依从性,改善生活质量,延长预后生存。

Objective To summarize the perioperative nursing measures for 23 patients treated with sequential bilateral lung transplantation. Methods Before treatment, the patients were conducted with health education, mental support, symptoms nursing and individual respiratory function training; after treatment, the patients were conducted with preventive nursing measures such as respiratory and circulatory systems monitoring, enteral nutrition treatment and nursing for postoperative complications such as acute rejection reaction; furthermore, the patients were conduct- ed with drug, diet, life and self - monitoring instructions after discharging from hospital. Results 23 patients completed the operations successfully, and 3 patients had hypovolemia, 5 patients had pulmonary infection, 11 patients had acute rejection reaction and 4 patients had airway stenosis. 19 patients survived and 4 patients died. Through the positive treatment and careful nursing, 19 pa- tients were cured and discharged from hospital. Conclusion Implementation of corresponding nurs- ing measures for patients with lung transplantation in perioperative period can effectively alleviate patients＇ psychological stress, improve therapeutic compliance and quality of life as well as prolong survival time.