漏斗胸微创矫正手术联合肺移植治疗1例漏斗胸致肺功能不全患儿的护理

Nursing care of a child with pulmonary insufficiency caused by pectus excavatum treated with minimally invasive correction surgery combined with lung transplantation

报告1例17岁儿童漏斗胸患儿行微创矫正手术联合左肺移植术后重症监护室的护理,此例儿童肺移植病程较长,病情复杂,护理难度高,重症监护室治疗期间,护理重点为肺移植护理、血流动力学监测、呼吸道护理、感染控制、容量管理、超早期康复等。患儿术后第22小时计划性拔除气管插管,第9天转出监护室,术后39 d出院,预后良好。在重症监护室护理中,该患儿肺移植术后未出现感染、呼吸衰竭、急性排异等并发症,护理效果显著,具有临床借鉴意义。

This paper reports a nursing case of a 17-year-old patient who received minimally invasive correction surgery and left lung transplantation.Specifically,this teenager patient lung transplantation had a longer duration,complex condition,and high nursing difficulties.During the course of treatment in Intensive Care Unit(ICU),the focal point of nursing lies in the nursing of lung transplantation,detection of haemodynamics,nursing of respiratory tract,infection control,capacity management,and ultra-early rehabilitation,etc.The target patient had planned extubation 22 hours later after the surgery,and was transferred to inpatient ward from ICU 9 days later,and was discharged from the hospital 39 days later.Meanwhile,the recovery of the patient was favorable.During the process of nursing in ICU,the patient was free of complications such as infection,respiratory failure and acute rejection.Consequently,this successful nursing case is of due clinical significance.