多发性骨折并发急性呼吸窘迫综合征患者行俯卧位通气治疗的护理

Nursing care of prone position ventilation in a patient with acute respiratory distress syndrome after multiple fractures

总结1例多发性骨折并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者行俯卧位通气治疗的护理体会。针对患者多发性骨折并发ARDS、病情进展迅速、传统俯卧位风险高等问题,采取组建多发骨折俯卧位通气多学科团队、实施改良式俯卧位翻身流程、俯卧位联合运用气道廓清技术促进肺康复、舒适化镇痛镇静提高俯卧位的耐受性、积极鼓励家属参与患者精神症状管理等措施。经7 d的治疗和护理,患者从ICU转入普通病房,术后第26天康复出院。

To summarize the nursing experience of prone position ventilation in a patient with acute respiratory distress syndrome(ARDS)after multiple fractures.In view of the patient with multiple fractures complicated with ARDS,rapid disease progression,high risk of traditional prone position and etc,key points of care included establishing a multidisciplinary team for prone position ventilation after multiple fractures,implementing a modified prone position turning process,combining the prone position with airway clearance technology to promote lung rehabilitation,providing comfort analgesia and sedation to improve the patient's tolerance of the prone position,and actively encouraging family members to participate in the patient's mental symptom management.After 7 days of treatment and care,the patient was transferred from the ICU to the general ward,recovered on the 26th day after surgery and was discharged.