总结4例肺移植术后支气管吻合口狭窄患者行支气管镜下治疗的经验。针对本组患者支气管镜下治疗并发症多且危急、低氧血症反复发作、居家期间自我症状监测能力缺失、康复缺乏连续性等问题,成立多学科协作管理团队;制订支气管镜下治疗围手术期安全护理计划;个体化氧疗策略精准实施;个案管理模式的自我症状监测与康复锻炼。4例患者经支气管镜下治疗及精心护理,随访6~12个月,移植肺功能良好,6 min步行试验>300 m,生活质量卡氏功能状态评分90分。
The experience of multidisciplinary collaborative care in four lung transplant patients complicated with bronchial anastomotic stenosis was summarized. In response to the problems that bronchoscopy has many critical and emergent complications,recurrent episodes of hypoxemia,lack of self-symptom monitoring ability,and lack of rehabilitation continuity,we set up multidisciplinary collaborative management team,formulated perioperative safety care plan of bronchoscopy,precisely implemented individualized oxygen therapy strategy,provided self-symptom monitoring and rehabilitation exercise in case management mode. Four patients were treated by bronchoscopy and carefully cared,and followed up for 6 to 12 months. The transplanted lung functioned well,and the patients per-formed 6-minute walk test with more than 300 m,and average score of Karnofsky functional status scale was 90 points.
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