上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (3): 406-408.doi: 10.3969/j.issn.1674-8115.2021.03.022

• 病例报告 • 上一篇    下一篇

1例新型冠状病毒肺炎危重型患者行体外膜氧合治疗中的气道管理

朱丽1(), 李云1, 奚慧琴2(), 王维俊1, 陈飞1, 陆詹婷1, 夏凌1, 占梦点1, 张天瑶1   

  1. 1.上海交通大学医学院附属仁济医院心血管外科,上海 200127
    2.上海交通大学医学院附属仁济医院护理部,上海 200127
  • 收稿日期:2020-04-17 出版日期:2021-03-28 发布日期:2021-04-06
  • 通讯作者: 奚慧琴 E-mail:julie_1227@126.com;renji_xhq@126.com
  • 作者简介:朱丽(1990—),女,护师,学士;电子信箱:julie_1227@126.com

Airway management in a critically ill patient with novel coronavirus pneumonia undergoing extracorporeal membrane oxygenation

Li ZHU1(), Yun LI1, Hui-qin XI2(), Wei-jun WANG1, Fei CHEN1, Zhan-ting LU1, Ling XIA1, Meng-dian ZHAN1, Tian-yao ZHANG1   

  1. 1.Department of Cardiovascular Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    2.Department of Nursing, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2020-04-17 Online:2021-03-28 Published:2021-04-06
  • Contact: Hui-qin XI E-mail:julie_1227@126.com;renji_xhq@126.com

摘要:

该文总结了1例新型冠状病毒肺炎危重型患者行体外膜氧合(extracorporeal membrane oxygenation,ECMO)治疗后肺功能改善的护理经验。该患者经口插管辅助通气、抗感染等对症支持治疗后,仍不能脱离呼吸机,并出现持续二氧化碳潴留,气体交换严重受损。予气管切开术和ECMO治疗;同时,采取吸痰护理、雾化吸入治疗、支气管冲洗和侧卧位通气联合体位引流等一系列改善肺功能的护理措施。经过7 d ECMO治疗及护理,患者肺部功能改善,予以撤机。

关键词: 新型冠状病毒肺炎, 体外膜氧合, 气道管理, 护理

Abstract:

This article summarizes the nursing experience in a critically ill patient with novel coronavirus pneumonia after extracorporeal membrane oxygenation (ECMO) treatment for lung function improvement. After oral intubation-assisted ventilation, anti-infection, and other symptomatic support treatments, the patient was still unable to breathe without the ventilator. For the sustained carbon dioxide retention and severe gas exchange impairment, he was treated with tracheotomy and ECMO. During the treatment, a series of nursing measures to improve lung function were adopted, such as sputum suction care, atomized inhalation therapy, bronchial irrigation, and lateral ventilation combined with postural drainage. After 7 days of ECMO treatment and nursing, the patient's lung function improved and then he was weaned from the machine.

Key words: new coronavirus pneumonia, extracorporeal membrane oxygenation (ECMO), airway management, nursing

中图分类号: