机械通气病人的气管插管护理体会

目的:总结机械通气患者气管插管的护理体会.方法:做好气管导管的护理,加强气道湿化,及时清除气道分泌物,预防感染,加强基础护理.结果:通过加强人工气道的管理和护理,从而减少了临床并发症的发生.讨论:只有采取科学有效的呼吸道护理,才能够确保呼吸机功能的实施,防止并发症的发生.     

舒适护理在经口气管插管机械通气清醒病人中的应用

总结了舒适护理在经口气管插管机械通气清醒病人中的应用,包括:舒适的心理护理、气管插管导管的舒适护理、机械通气的舒适护理、吸痰的舒适护理、口干、口渴的舒适护理、体位的舒适护理、沟通障碍的舒适护理、睡眠的舒适护理.认为对病人行机械通气时,应加强满足病人舒适的需求,严密做好各方面的护理,才能达到良好的治疗效果.     

肝移植术后经口气管插管患者的口腔护理

总结了38例肝移植术后经口气管插管患者的日常口腔护理经验,主要包括:插管术前配合,口腔护理材料准备,口腔护理时操作配合,口腔护理后导管的固定与观察,口腔擦洗加冲洗法的实施.认为提高口腔护理质量能减少并发症的发生,且让患者感觉更加舒适和人性化.     

重症有机磷农药中毒患者在气管插管下洗胃的急救护理

总结了54例重症急性有机磷农药中毒患者在气管插管下洗胃的急救护理经验,认为在气管插管下洗胃,可使胃管置入快速、安全、有效,并有利于防止窒息的发生,减少呼吸心跳骤停发生率并提高其抢救成功率.     

气管插管术院前急救的体会

目的:总结 气管插管在急救中应用的经验,以期提高整体急救水平.方法:回顾性分析36例院前气管插管抢救危重病人的资料.结果:36例急诊气管插管中,30例为一次插管成功,成功率为83.3%;6例为二次插管后成功,插管时间＜5min.5例中毒予以现场气管插管,成功建立人工通气后,经进一步抢救全部存活;12例脑出血的病人行现场气管插管后,10例安全转运至医院治疗,2例死于脑疝;11例心性猝死患者中,气管插管后9例未能恢复有效循环死亡,2例溺水患者和6例不明原因呼吸心搏骤停患者,行现场气管插管后抢救无效死亡.结论:气管插管是院前抢救危重病人的基础,对保证进一步心肺复苏,提高危重患者抢救成功率有重要意义.     

颅脑外伤气管切开患者的护理

总结了57例颅脑外伤后气管切开患者的护理方法和体会.通过对颅脑外伤气管切开患者实施有效的护理措施、积极预防肺部感染等并发症,减少了患者的死亡率.气管切开是救治颅脑外伤患者的关键措施,而注重气管切开患者的护理是颅脑外伤患者康复过程中一个重要环节,有效的气管护理有利于患者康复.     

呼吸科患者机械通气的心理护理

在呼吸科,机械通气的范围,已不仅限于抢救危重呼吸衰竭及呼吸停止,也多用于缓解缺氧和二氧碳潴留,改善通气换气功能,减少呼吸做功,缓解呼吸肌疲劳,使患者及早地改善呼吸功能.因此,机械通气已成为目前治疗中常用、有效的治疗措施.病人在接受机械通气,特别是有创通气治疗抢救期间,面临着死亡的威胁、治疗的痛苦、疾病的反复、环境的陌生、沟通的障碍等应激源的刺激,促使病人产生一系列的心理问题,因此,做好机械通气病人的心理护理就更为重要.     

机械通气治疗呼吸衰竭患者的护理

目的:探讨机械通气治疗呼吸衰竭患者的护理措施及方法.方法:对我院近3年来使用机械通气抢救11例呼吸衰竭患者的护理措施进行回顾性总结,报道.结果:11例呼吸衰竭患者中,机械通气时间<48h4例,48-72h4例,>72h3例,均顺利撤机.结论:机械通气是目前治疗呼吸衰竭患者较为有效,安全,可行的方法.严密的病情观察,有效的呼吸道湿化,吸痰时机和方法的正确掌握是呼吸衰竭患者机械通气得到成功救治的关键.     

改良气管插管固定带在ICU中的应用

目的 探讨改良气管插管降低气管插管病人脱管的发生率及其口角损伤发生率的效果.方法 将223例气管插管病人随机分为观察组与对照组.观察组115例,使用改良气管插管固定带;对照组108例,使用传统白扁带固定.比较2种方法气管插管脱出及口角损伤发生率.结果 观察组病人气管插管脱出率、口角损伤发生率显著低于对照组(p<0.01).结论 改良气管插管固定带能有效降低气管插管脱管及口角损伤,值得在临床中推广.     

A rare cause of accidental selective intubation: right upper lobar bronchus originating from the trachea

IKs channels are composed of IsK and KvLQT1 subunits and underly the slowly activating, voltage-dependent IKs conductance in heart. Although it appears clear that the IsK protein affects both the biophysical properties and regulation of IKs channels, its role in channel pharmacology is unclear. In the present study we demonstrate that KvLQT1 homopolymeric K+ channels are inhibited by the IKs blockers 293B, azimilide and 17-beta-oestradiol. However, IKs channels induced by the coexpression of IsK and KvLQT1 subunits have a 6-100 fold higher affinity for these blockers. Moreover, the IKs activators mefenamic acid and DIDS had little effect on KvLQT1 homopolymeric channels, although they dramatically enhanced steady-state currents through heteropolymeric IKs channels by arresting them in an open state. In summary, the IsK protein modulates the effects of both blockers and activators of IKs channels. This finding is important for the action and specificity of these drugs as IsK protein expression in heart and other tissues is regulated during development and by hormones.     

The univent tube can facilitate difficult intubation in a patient undergoing thoracoscopy

A case of a subcutaneous haemangioma of the hand clinically mimicking a glomus tumour is described. Other discrete small hand tumours that may present with the triad of pain, tenderness and cold intolerance are discussed.     

The use of the laryngeal mask in a female patient with an unpredictable difficult intubation

A laryngeal mask was used after repeated ineffective attempts at intubation. Preoperative examinations failed to defect signs of a possible difficult intubation. Laryngoscopy showed a true glottis, but it was impossible to insert tube No. 6 in the trachea. Failure of attempts at intubation made us use a laryngeal mask for maintaining the patency of the upper airways. Anesthesia coursed smoothly in the presence of stable hemodynamics and gas exchange. Use of laryngeal mask helped solve the problem of unpredictable difficult intubation and provide reliable patency of the upper respiratory airways in a female patient with latent stenosis of the subglottal space.     

Emergency intubation with the Combitube in a patient with persistent vomiting

Prompt establishment of a patient airway and effective ventilation are the major goals during initiation of cardiopulmonary resuscitation in patients with cardiac arrest. Endotracheal intubation is the definitive method to maintain an optimal airway. However, endotracheal intubation is not always possible, even for the skilled physician. The Combitube has been developed to overcome this disadvantage. Studies have proved the effectivity of ventilation with this device. A case is reported where a patient suffered from acute respiratory failure and attempts at endotracheal intubation failed due to continued vomiting rendering fibre-optical visualisation of the vocal cords impossible. Blind insertion of the Combitube led to successful ventilation, and hence replacement by an endotracheal airway could be performed without danger of aspiration.     

老年患者人工髋关节置换术的护理体会

目的:探讨老年人工髋关节置换术的护理方法.方法:对32例髋关节置换术患者加强生命体征监测和患肢护理,预防并发症,并指导合理的功能锻炼.结果:术后发生电解质紊乱1例,脱位1例,经积极治疗均痊愈出院.结论:对老年患者的正确护理和康复训练,可促进病情康复,提高生活质量.     

Mediastinal abscess diagnosed after its rupture into the trachea in a patient after esophagectomy

A 52-yr-old man with esophageal cancer underwent esophagectomy and retrosternal reconstruction using stomach under general anesthesia. In the postoperative period, the patient developed mediastinal abscess which failed to be diagnosed by daily routine chest X-rays, because of surgical alterations of mediastinal anatomy. On the 11th postoperative day, the abscess ruptured into the trachea and severe hypoxemia (PaO2 73 mmHg, FIO2 1.0) developed while the patient was still on mechanical ventilation. A chest X-ray on that day showed a radiolucent cavity with defined margins in the right superior mediastinum. Thoracic CT scanning on the 15th postoperative day disclosed a capsulated cavity which indicated abscess formation in the posterior mediastinum. Although surgical drainage was not undertaken, the patient's severe hypoxemia was resolved within 4 days by the supportive therapies including chest physiotherapy, postural drainage and administration of antibiotics and corticosteroids. Although mediastinal abscess after esophagectomy is a rare complication, it may rupture into the trachea and lead to severe hypoxemia. In this case thoracic CT scanning was useful to detect the mediastinal abscess which had not been diagnosed by routine chest X-rays.     

危重病人转运过程中的病情观察及护理

探讨和分析急危重病人安全转运过程中的病情观察和护理,完善急救转运措施流程,尽可能保持生命体征平稳,病情稳定,安全转运到目的地进行确定性治疗,防止发生医疗纠纷.     

子宫切除病人围手术期的心理护理

探讨了子宫切除病人围手术期的心理护理.方法:对患者实施了术前心理护理、解除焦虑心理、术后心理护理等护理措施.结果:358例子宫切除病人无一列产生并发症,术后痊愈出院.结论:通过对子宫切除病人围手术期的心理护理,是病人术前情绪稳定,配合治疗,术后恢复快.