膈肌折叠术治疗婴幼儿心内直视术后膈肌麻痹的护理

目的探讨膈肌折叠术在婴幼儿心内直视术后膈肌麻痹中的应用及护理。方法对9例心内直视术后膈肌麻痹患儿实施膈肌折叠术治疗,术后密切监测患儿生命体征变化,定时复查动脉血气,纠正水、电解质酸碱平衡紊乱,加强循环系统的观察及处理,常规进行气道管理、胃肠道的护理、营养支持等。结果术中无并发症。9例患儿中除1例二次插管外,其余8例一次性顺利脱离呼吸机,胸片显示膈肌均恢复到正常位置,康复出院。结论密切的病情观察、积极有效的护理对于膈肌折叠术后先心病患儿康复十分有利。

Nursing care of infants with diaphragm paralysis after open heart surgery undergoing diaphragmatic plication

Objective To explore diaphragmatic plication applied to infants with diaphragm paralysis after open heart surgery,and to summarize the experience of nursing care.Methods Nine cases of diaphragm paralysis after open heart surgery received diaphragmatic plication.After the operation,nurses closely monitored patients′vital signs,regularly checked arterial blood gas,corrected fluid,electrolytes and acid-base imbalance,strengthened monitoring of the circulatory system,and conducted routine airway ma-nagement,gastrointestinal care and nutritional support.Results There was no complication during the operation.One patient had undergone second endotracheal intubation,the others were weaned successfully from ventilator.Chest X-ray showed the diaphragm was restored to normal position,and all patients recovered and were discharged.Conclusion Close observation of patients′condition,and active and effective care are beneficial to recovery of children with congenital heart disease undergoing diaphragmatic plication.