腔镜手术中CO_2气腹致全身广泛皮下气肿的护理干预

The nursing intervention for the whole-body extensive subcutaneous emphysema caused by the CO_2 pneumoperitoneum during the endoscopic operation

目的：总结腔镜手术过程中二氧化碳（CO_2）气腹致全身广泛皮下气肿的护理干预措施。方法：回顾性分析2013年1月～2015年4月腔镜手术术中CO_2气腹致全身广泛皮下气肿11例患者,加强对患者的皮下气肿范围、呼吸以及循环功能的观察和监测,并且协助医师进行麻醉、排气等治疗,降低患者腹部气压以及流速,做好对患者进行开腹的手术准备。结果：11例患者中,经过合理的护理干预措施和正确有效的治疗,9例患者在平稳后继续进行原手术,2例患者经护理干预和治疗后,中途转为开腹手术,所有患者经过1～2 h的术后恢复,均安全返回病房。结论：对腔镜手术术中CO_2气腹致全身广泛皮下气肿进行及时有效的护理,以及对各项指标的严密监测、及时的治疗,能够使患者安全的度过围术期。

Objective： To summarize the nursing intervention measures for the whole- body extensive subcutaneous emphysema caused by the carbon dioxide（ CO_2） pneumoperitoneum during the endoscopic operation. Methods： Make retrospective analysis of 11 cases of patients who had the whole- body extensive subcutaneous emphysema caused by the CO_2 pneumoperitoneum during the endoscopic operation from January 2013 to April 2015. On the basis above,through strengthening the observation and supervision of the patients＇ subcutaneous emphysema scope,breath and circulatory function,assisting the physician with the therapies of anesthesia and aerofluxus and reducing patients＇ abdominal pressure and velocity,make good preparation for the laparotomy given to the patients. Results： Through reasonable nursing intervention and correct and effective treatment,9 out of 11 cases continued the original operation as their subcutaneous emphysema came to a steady state,and the other 2 cases transferred to laparotomy in the middle of the original operation. All the patients had postoperative recovery for 1to 2 hours and then returned to their wards safely. Conclusion： Conducting prompt and effective nursing intervention for the whole- body extensive subcutaneous emphysema caused by the CO_2 pneumoperitoneum during the endoscopic operation and implementing tight supervision of all indicators involved and timely treatment can ensure the patients safely go through the perioperative period.