上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (5): 548-.doi: 10.3969/j.issn.1674-8115.2013.05.005

• 专题报道（临床护理与管理） • 上一篇    下一篇

重型颅颌面损伤患者急性期呼吸道的护理

赵 燕, 朱 颖, 阮 洪   

  1. 上海交通大学 医学院附属第九人民医院神经外科, 上海 200011
  • 出版日期:2013-05-28 发布日期:2013-05-28
  • 通讯作者: 阮 洪, 电子信箱: ruanh2428@2m9h.net。
  • 作者简介:赵 燕(1981—), 女, 护师； 电子信箱: tailimm@163.com。

Nursing strategy for respiratory tract of patients with severe craniofacial trauma in acute stage

ZHAO Yan, ZHU Ying, RUAN Hong   

  1. Department of Neurosurgery, the Ninth People´s Hospital, |Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2013-05-28 Published:2013-05-28

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摘要：

目的 探讨重型颅颌面损伤患者急性期呼吸道的护理措施。方法 收集151例重型颅颌面损伤患者的临床资料，对患者的临床特点、护理措施及治疗结局进行回顾性分析。结果 151例患者中，23例因呼吸困难、血氧饱和度低，入院即行气管切开；128例给予口或鼻咽通气道维持呼吸道通畅，其中14例患者渡过急性期，71例患者因病情发生恶化需开颅手术，同时行气管切开；43例患者因血氧饱和度进行性下降（低于93%）而行气管切开。结论 早期积极有效地放置口咽通气道，严密观察患者病情变化，适时合理地实施气管切开，可减少重型颅颌面损伤患者急性期低氧血症的发生。

关键词: 重型颅颌面损伤, 口咽通气道, 血氧饱和度, 气管切开

Abstract:

Objective To explore the nursing strategy for respiratory tract of patients with severe craniofacial trauma in acute stage. Methods The clinical data of 151 patients with severe craniofacial trauma were collected, and the clinical manifestations, nursing measures and treatment outcomes were retrospectively analysed. Results Twenty-three patients received tracheotomy due to dyspnea and lower blood-oxygen saturation on admission. Oropharyngeal or nasopharyngeal airway insertion were performed for 128 patients, among whom 14 got through the acute stage, and another 71 underwent tracheotomy and intracranial operation due to disease deterioration. Tracheotomy was conducted in 43 patients due to the gradual decrease of blood oxygen saturation (lower than 93%). Conclusion Effective oropharyngeal airway insertion, intensive monitoring of disease condition and proper tracheotomy could decrease the incidence of hypoxemia in patients with severe craniofacial trauma in acute stage.

Key words: severe craniofacial trauma, oropharyngeal airway insertion, blood oxygen saturation, tracheotomy