总结1例鼻咽癌患者介入栓塞术中突发大出血窒息抢救成功的护理体会。患者术中颌面部突发大出血,立即翻身侧卧、体位引流同时负压吸引,但血液流入呼吸道速度过快,负压吸引不全,发生窒息,立即采用改良海姆立克急救法,将患者安置右侧俯卧位行海姆立克法,成功清理呼吸道。抢救时多学科团队密切配合,做好术中体位、管道、气道管理及抢救物资准备。经过积极抢救及护理,成功挽救患者生命,顺利完成介入栓塞止血术。患者术后第1天脱离有创呼吸机,第13天行颌面部清创及皮瓣移植术,第18天行右侧鼻咽及口腔黏膜重建术,于第75天创面完全愈合出院。
The successful nursing experience of sudden massive hemorrhage and asphyxia during interventional embolism in a patient with nasopharyngeal carcinoma was summarized. The patient suffered from sudden maxillofacial bleeding during surgery,and he was immediately turned over,body drainage and the negative pressure attraction were both used,but the blood flowed into the respiratory tract too fast and the negative pressure attraction was incomplete,asphyxia occurred. The modified Heimlich emergency method was immediately adopted. The patient was placed in the right prone position to perform Heimlich maneuver,and the respiratory tract was successfully cleared. During the rescue,the multidisciplinary team cooperated closely to prepare the intraoperative body position,pipeline,airway management and rescue materials. After active rescue and nursing,the patient was saved,and the interventional embolization and hemostasis surgery was successfully completed. The patient was weaned from the invasive ventilator on postoperative day 1,received maxillofacial debridement and flap trans-plantation on day 13,and right nasopharyngeal and oral mucosa reconstruction on day 18,and was discharged with complete wound healing on day 75.
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