腰椎结核围手术期并发心肺功能不全患者的肺康复护理

doi:10.3761/j.issn.2096-7446.2025.10.015

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (10): 1229-1231.doi: 10.3761/j.issn.2096-7446.2025.10.015

腰椎结核围手术期并发心肺功能不全患者的肺康复护理

张春霞(), 张晓琳(), 张燕, 李冰, 陈志, 盛莉, 杨慧, 尤娜娜

100091 北京市解放军总医院第八医学中心结核病科ICU/重症医学科

收稿日期:2025-02-13 出版日期:2025-10-10 发布日期:2025-09-25
通讯作者: 张晓琳，E-mail：luckylin77@163.com
作者简介:张春霞：女，本科，副主任护师，护士长，E-mail：zhangchunxia2023@sina.com

Pulmonary rehabilitation nursing for a patient with lumbar tuberculosis and comorbid cardiopulmonary dysfunction during the perioperative period

ZHANG Chunxia(), ZHANG Xiaolin(), ZHANG Yan, LI Bing, CHEN Zhi, SHENG Li, YANG Hui, YOU Nana

Received:2025-02-13 Online:2025-10-10 Published:2025-09-25

摘要/Abstract

摘要：

总结1例腰椎结核围术期并发心肺功能不全患者的肺康复护理体会。护理要点：针对患者腰椎结核术并发心肺功能不全后，存在体位受限、容量负荷过重、疼痛、痰液潴留及呼吸肌功能障碍等肺康复护理难点，采用改良式体位管理，降低手术节段剪切力、增加肺通气；精细化容量与疼痛管理，减轻心肺负荷，做好肺康复前置性准备；肺超声引导下分层气道廓清，改善痰液清除效率，优化气体交换效能；进阶主动呼吸循环技术及轴向安全运动方案，促进呼吸肌和骨骼肌的协同重建。经过17 d精心治疗和护理，患者顺利转出监护室继续康复治疗。

关键词: 结核, 脊柱, 心力衰竭, 呼吸困难, 引流, 体位, 危重病护理

Abstract:

To summarize pulmonary rehabilitation nursing for a patient with lumbar tuberculosis and complicated with cardiopulmonary dysfunction. For the patient with lumbar tuberculosis complicated by cardiopulmonary insufficiency，there were some difficulties in pulmonary rehabilitation nursing，such as restricted positioning，fluid overload，pain，sputum retention and respiratory muscle dysfunction. Interventions were taken，including optimized positioning to reduce spinal shear forces and improve ventilation，refined volume and pain management to decrease cardiovascular strain and prepare for pulmonary rehabilitation as a prerequisite，ultrasound-guided targeted airway clearance to enhance sputum removal and gas exchange；and advanced active respiratory techniques combined with axial-stabilized exercises to promote the coordinated reconstruction of respiratory and skeletal muscles. Following 17 days of specialized care，the patient successfully transitioned from ICU to continued rehabilitation.

Key words: Tuberculosis, Spinal, Heart Failure, Dyspnea, Drainage, Postural, Critical Care Nursing

张春霞, 张晓琳, 张燕, 李冰, 陈志, 盛莉, 杨慧, 尤娜娜. 腰椎结核围手术期并发心肺功能不全患者的肺康复护理[J]. 中华急危重症护理杂志, 2025, 6(10): 1229-1231.

ZHANG Chunxia, ZHANG Xiaolin, ZHANG Yan, LI Bing, CHEN Zhi, SHENG Li, YANG Hui, YOU Nana. Pulmonary rehabilitation nursing for a patient with lumbar tuberculosis and comorbid cardiopulmonary dysfunction during the perioperative period[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1229-1231.

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腰椎结核围手术期并发心肺功能不全患者的肺康复护理

Pulmonary rehabilitation nursing for a patient with lumbar tuberculosis and comorbid cardiopulmonary dysfunction during the perioperative period

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