心脏穿透伤患者的急救及术后护理

The First Aid and Nursing of Patients with Heart Penetrating Wound

目的探讨心脏穿透伤患者急救与术后护理要点及措施。方法对14例心脏穿透伤患者均迅速建立多条静脉通道,快速输液,中流量吸氧,在尽可能短的时间内开胸修补心脏、心包开窗引流及处理其他复合伤,术后监测生命体征,加强呼吸、循环系统及引流管的管理。结果 14例患者中抢救成功12例,抢救无效死亡2例,存活组中1例术后第9d 再次并发心包填塞,经心包穿刺置管引流不畅,再次行剖胸探查切除大部分心包及充分引流后治愈,其他存活者无并发症发生。结论快速输液、中流量吸氧、尽快手术是心脏穿透伤患者抢救成功的关键,术后应重点加强循环系统、呼吸系统及引流管的管理,尤其应预防术后再次发生心包填塞。

Objective To study the key points of the first aid and nursing measures of the patients with heart pene- tration wounds.Methods All of 14 cases were studied by seting up many vein channels,transfusion fastly,inhaling oxygen, opening chest to repairing the cardiac injury in as soon as possible and dealing with other wounds,And we focused on the management of monitoring vital signs,strengthening respiratory,circulation system and drainage tube alter operation.Results 12 out of 14 patients had been cured,and 2 died.Conclusion Transfusion lastly,inhaling oxygen and operating as soon as possible were the key points of curing patients.The circulation system,respiratory system and drainage tube should be man- aged closely,especially after the operation.