吸入性损伤及其气管切开的预见性护理

目的:总结吸入性损伤病人实施气管切开的预见性护理经验,完善其护理措施。方法:对2004年1月- 2005年6月收治的56例吸入性损伤病人,在确诊为吸人性损伤的初期,气管切开前、后,拔管时与拔管后等时相进行预见性护理,一旦发现病人有气管切开指征,在做好护理急救的同时及时报告医生。结果:56例患者中,5例重度吸入性损伤病人均在预见性护理的信息提示下实行了气管切开,轻度和中度病人未实行气管切开手术;除1例高龄大面积烧伤(97％ TBSA)早期死亡外,其余均痊愈。结论:吸入性损伤的主要治疗与护理原则在于保持呼吸道通畅和是否实施气管切开与何时切开,预见性护理可为临床诊断治疗提供重要信息,有效防止呼吸道堵塞和并发症的发生。

Foreseeing nursing of inhalation injury and tracheotomy

Objective: To sum up the experience in nursing burn patients complicated by inhalation injury and to be subjected to tracheotomy with foreseeing nursing measures. Method: 56 patients with inhalation injury were nursed by taken foreseeing measures at different stages, such as at the early stage after diagnosis, before and after tracheotomy, before and after removing the cannula, etc. Once the indication of tracheotomy emerged, emergency treatment and nursing should be started and the doctor should be informed timely. Result: Among the 56 cases, 5 cases had severe inhalation injury, under foreseeing nursing, they were subjected to tracheotomy as the indication of tracheotomy emerged. Patients with moderate and slight inhalation injury did not receive the operation. All the patients were cured, except one old patient with large area burn (97%TBSA) died at the early stage. Conclusion: The principle of nursing of inhalation injury is to keep the respiratory tract unobstructed. It is important to make correct decision whether tracheotomy should be performed or not, and at what time tracheotomy should be performed. Foreseeing nursing can provide important information to make the decision and to prevent respiratory tract obstruction and other complications.