ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (2): 151-153.doi: 10.3761/j.issn.2096-7446.2023.02.012

• 重症护理研究 • 上一篇    下一篇

肝移植术后急性呼吸窘迫综合征患者俯卧位通气的护理

鲁海飞, 封秀琴, 王丽竹, 张刘, 钱彦颖   

  1. 310009 杭州市 浙江大学医学院附属第二医院外科重症医学科(鲁海飞,张刘,钱彦颖),护理部(封秀琴,王丽竹)
  • 收稿日期:2022-04-23 出版日期:2023-02-10 发布日期:2023-02-09
  • 通讯作者: 封秀琴,E-mail:fengxiuqin@zju.edu.cn
  • 作者简介:鲁海飞:女,本科,主管护师,E-mail:2503088@zju.edu.cn

Nursing of prone position ventilation for acute respiratory distress syndrome after liver transplantation: a case report

LU Haifei, FENG Xiuqin, WANG Lizhu, ZHANG Liu, QIAN Yanying   

  • Received:2022-04-23 Online:2023-02-10 Published:2023-02-09

摘要: 总结1例劈离式肝移植重症患者术后并发呼吸窘迫综合征行个体化俯卧位通气的护理体会。护理要点:针对该案例术后肝断面易出血,俯卧位腹部受压风险大,在充分评估、有效固定患者腹部伤口的情况下实施个体化俯卧位通气方案;持续动态监测腹内压;以腹内压为导向进行体位管理及肠内营养策略调整;加强俯卧位期间腹腔引流管的观察与护理。患者术后5 d内共实施4次俯卧位通气治疗,治疗后患者肺功能明显好转,无肝脏出血、移位等不良事件发生。术后第5天顺利拔除气管插管,术后第39天康复出院。

关键词: 劈离式肝移植, 俯卧位, 腹内压, 危重病护理

Abstract: To summarize the nursing of individualized prone ventilation in a critically ill patient with postoperative respiratory distress after split liver transplantation. In this case,the postoperative liver section was prone to bleeding and it had a high risk of abdominal compression under the prone position,a modified prone position ventilation scheme was implemented with adequate assessment and effective immobilization of the patient's abdominal wound. And continuous and dynamic monitoring of intra-abdominal pressure,adjustment of position and enteral nutrition strategy guided by intra-abdominal pressure,strengthening of observation and care for abdominal drainage tube during prone position were adopted. The lung function of the patient improved significantly after four times of prone position ventilation within 5 days after the operation and no adverse events such as hemorrhage and displacement of liver occurred. The tracheal intubation was successfully removed on the 5th day after the operation urgery,and the patient recovered and was discharged from the hospital on the 39th day.

Key words: Split Liver Transplantation, Prone Position, Intra-abdominal Pressure, Critical Care Nursing