To summarize the nursing experience of a patient with type A aortic dissection and grade Ⅳ difficult airway who underwent aortic dissection surgery and uvulopalatopharyngoplasty. In view of the patient's hemodynamic disorders,volume disorders and other problems,we maintained hemodynamic stability and volume dynamic balance. For acute respiratory insufficiency,individualized lung protective ventilation measures were adopted to prevent ventilator-associated pneumonia. According to the nursing difficulties and emphases of the airway with grade Ⅳ difficulty after aortic dissection,emergency artificial airway preplan was established to prevent unplanned extubation and throat bleeding,and sequential tracheal intubation extubation was implemented. The patient was given a risk hierarchy based on his high risk of delirium,early stage activities were enhanced. After 31 days of intensive care,the patient recovered well and was discharged.
WEI Jianhua
,
HE Guojun
,
SANG Ming
,
ZHU Hongwu
,
WENG Fengxia
. Nursing of a patient undergoing uvulopalatopharyngoplasty after type A aortic dissection[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022
, 3(5)
: 455
-457
.
DOI: 10.3761/j.issn.2096-7446.2022.05.015
[1] Okita Y,Miyata H,Motomura N,et al.A study of brain pro-tection during total arch replacement comparing antegrade cerebral perfusion versus hypothermic circulatory arrest,with or without retrograde cerebral perfusion:analysis based on the Japan Adult Cardiovascular Surgery Database[J]. J Thorac Car-diovasc Surg,2015,149(2):S65-S73.
[2] Thurau J,Habazettl H,El Al Md AA,et al. Left ventricular systolic dysfunction in patients with type-A aortic dissection is associated with 30-day mortality[J]. J Cardiothorac Vasc Anesth,2019,33(1):51-57.
[3] 井凤云,王军,郭向阳. 困难气道评估的临床应用进展[J]. 中国微创外科杂志,2019,19(4):363-366.
Jing FY,Wang J,Guo XY.Clinical application of difficult airway assessment[J]. Chin J Minim Invasive Surg,2019,19(4):363-366.
[4] Apfelbaum JL,Hagberg CA,Connis RT,et al.2022 American Society of Anesthesiologists practice guidelines for management of the difficult airway[J]. Anesthesiology,2022,136(1):31-81.
[5] 李玉杰,韩伟,黄炜,等. 加速康复外科在44例悬雍垂腭咽成形术中的应用[J]. 山东大学学报(医学版),2020,58(11):92-97,102.
Li YJ,Han W,Huang W,et al.Application of enhanced recovery after surgery in 44 cases of uvulopalatopharyngoplasty[J]. J Shandong Univ Heal Sci,2020,58(11):92-97,102.
[6] 徐向朋,高玉芳,张彬彬,等. Stanford A型主动脉夹层患者术后拔除气管插管预防性给予高流量氧疗的效果评价[J]. 中华护理杂志,2018,53(5):568-572.
Xu XP,Gao YF,Zhang BB,et al.Evaluation of the effects of precautionary high-flow oxygen therapy in patients undergoing tracheal intubation after Stanford type A aortic dissection[J]. Chin J Nurs,2018,53(5):568-572.
[7] 翁峰霞,徐之鹏,卫建华,等. 早期活动强化策略对ICU后综合征患者预后的影响[J]. 中华急危重症护理杂志,2021,2(3):216-220.
Weng FX,Xu ZP,Wei JH,et al.Effect of early activity inten-sities on prognosis of patients with post-ICU syndrome[J]. Chin J Emerg Crit Care Nurs,2021,2(3):216-220.
