紧急气管支气管支架置入治疗恶性气道狭窄的效果及护理管理特点

Effect and nursing management characteristics of emergency tracheobronchial stent implantation in the treatment of malignant airway stenosis

目的分析紧急气管支气管支架置入治疗恶性气道狭窄的效果及护理管理特点。方法收集12例经纤维支气管镜引导下紧急置入气管支气管支架治疗恶性气道狭窄的危重症患者的病例资料。分析患者的气促评级、血气分析指标、临床症状改善情况及并发症发生情况。结果12例患者均成功置入气管支气管支架。患者术后的气促评级、PaO_(2)、PCO_(2)均优于术前(P<0.05)。咳嗽、咯血、吞咽困难等并发症轻微,术后1 d复查胸部X线无支架移位、脱落等现象发生。结论恶性气道狭窄危重患者经纤维支气管镜引导紧急置入气管支气管支架的姑息性治疗,可明显改善临床症状。精细化护理管理在整个手术过程起着至关重要的作用。

Objective To analyze the effect and nursing management characteristics of emergency tracheobronchial stent implantation in the treatment of malignant airway stenosis.Methods The case data of 12 cases of critically ill patients with malignant airway stenosis who were urgently placed with tracheobronchial stents under the guidance of fiberoptic bronchoscopy were collected.The shortness of breath rating,blood gas analysis index,improvement of clinical symptoms and occurrence of complications of the patients were analyzed.Results All 12 patients were successfully placed with tracheobronchial stents.The shortness of breath rating,PaO_(2)and PCO_(2)of the patients after operation were better than those before operation(P<0.05).Complications such as cough,hemoptysis and dysphagia were mild,and no stent displacement or shedding occurred on the chest X-ray reexamination at 1 d after operation.Conclusion The palliative treatment of critically ill patients with malignant airway stenosis guided by fiberoptic bronchoscopy with emergency placement of tracheobronchial stents can significantly improve clinical symptoms.Refined nursing management plays a vital role in the entire surgical process.