30例创伤性膈肌损伤患者的观察和护理

目的:探讨创伤性膈肌损伤的病情观察和护理,以期指导临床工作。方法:回顾性分析30例创伤性膈肌损伤患者的诊断治疗、病情观察、急救护理资料。结果:本组30例患者中,治愈出院26例,治愈率87%,死亡2例,转院治疗2例。结论:创伤性膈肌损伤属于严重胸腹联合伤,病情急、重、变化快,早期缺乏特异性临床表现,易被合并伤的症状掩盖,导致误诊和漏诊。在护理该类或疑似病例时,严密的病情观察,预见性病情评估,及时准确客观反应病情,积极配合医生完成各项急救,耐心细致的心理疏导,严格的呼吸道管理,有效镇痛、周到细致导管护理、饮食和活动的康复指导是抢救治疗该类患者成功的关键。

The Observation and Aid Care of 30 Cases with Injury of Diaphragm

Objective：To investigate the observation and aid care of the the patients with injury of diaphragm in order to direct the clinical work. Method：Retrospective analysis of the stats of 30 patients with injury of diaphragm in the diagnosis-treatment-observation-the first aid care.Result：In 30 patients,26 cases were cured,the cure rate was 87%,2 cases of death and 2 cases of the group was transfered to another hospital.Conclusion：The injury of diaphragm is one of the severe thoraco-abdominal injuries,which is acute,severe and changeable.The lack of the specific clinical manifestation in early stage leads to the misdiagnosis and underdiagnosis.The keys to increase the success rate of the salvage and treatment are careful observation,foreseeable evaluation,timely reaction,active cooperation with the doctor,patient psychological counseling,strict management of the airway,available way to relieve pain,careful nursing of the duct and rehabilitation guidance of the diet and exercise.