先天性心脏病术后并发膈肌麻痹的护理

目的总结先天性心脏病术后膈肌麻痹患儿的护理要点。方法对51例先天性心脏病术后并发膈肌麻痹患儿加强呼吸道管理,防治肺部感染;拔除气管插管后积极应对喉头水肿、支气管痉挛等并发症。结果29例患儿呼吸困难症状轻,术后顺利撤离呼吸机;22例反复撤机失败行膈肌折叠术,其中19例膈肌折叠后顺利撤机痊愈出院,3例死亡。结论先天性心脏病术后撤离呼吸机过程中应密切观察病情变化,及时评估膈肌功能及采取有效的护理措施,对于并发膈肌麻痹患儿的康复至关重要。

Nursing care of children developing diaphragmatic paralysis after correction surgeries for congenital heart diseases

Objective To summarize nursing care of children developing diaphragmatic paralysis after correction surgeries for congenital heart diseases.MethodsA total of 51 children after cardiac surgery developed diaphragmatic paralysis.They were given mecha-nical ventilation and preventive measures against pulmonary infection.After removal of endotracheal tube,children were closely observed for such complications as laryngeal edema,bronchial spasm,etc.ResultsAmong 51 children,29 children had mild dyspnea,and were able to wean off ventilation;22 had diaphragm plication after repeated attempts to wean off ventilation.Among those who had diaphragm plication,19 cases were able to wean off ventilation and were discharged,while 3 cases died.ConclusionPatients after receiving surgery for congenital heart diseases should be observed closely during ventilation weaning.It is important to timely assess the diaphragmatic function of patients and take effective nursing measure for those developing diaphragmatic para-lysis after cardiac surgery.