46例超高龄患者肺癌开胸术后呼吸道的护理

Nursing intervention to prevent respiratory tract complication after pneumonectomy in 46 elderly patients with lung cancer

目的探讨80岁以上高龄肺癌患者开胸术后呼吸道的护理措施,总结护理效果,从而降低肺部并发症的发生,提高肺癌患者手术效果。方法回顾解放军海军总医院胸外科2010年8月—2013年6月收治的46例80岁以上高龄肺癌患者资料,对制定的个体化围术期呼吸道护理措施进行总结分析。结果本组患者在围手术期全面地评估患者的全身状况,采取有计划、有目的个体化护理措施,降低了开胸术后肺部并发症的发生,全组肺叶切除26例,局部切除20例,术后发生呼吸道并发症7例,经及时治疗后均治愈出院。结论高龄患者因胸廓和肺的顺应性下降心肺功能低下,肺的生理储备能力低下,另外,开胸手术创伤大、时间长,容易出现呼吸道并发症。对80岁以上高龄肺癌患者,采取个体化呼吸道护理措施,可减少肺部并发症的发生,提高手术治疗效果。

Objective To explore the nursing interventions to prevent the respiratory tract complications after pneumonectomy in elderly lung cancer patients aged more than 80 years old,summarize the efficacy of nursing care,reduce the incidence of pulmonary complications and improve surgical results. Methods The clinical data of 46 cases of lung cancer patients with pneumonectomy in our hospital from August 2010 to June 2013 were reviewed retrospectively. The perioperative individualized nursing intervention was analyzed. Results The perioperative general condition of all patients were evaluated,the individualized nursing intervention was performed,the incidence of pulmonary complications decreased. 26 cases were with lobectomy,20 cases with partial resection; 7 cases were with pulmonary complications after the operations,and were cured and discharged timely. Conclusion Because of the decreased chest wall and lung compliance,decreased heart and lung function,low lung＇s physiologic reserve,severe wound of operation,respiratory complications are common in elderly patients. For patients over the age of 80,the individualized nursing intervention can reduce the incidence of pulmonary complications and improve surgical outcomes.