【作者】 王敏； 金普乐； 陶仁海； 刘俊霞；

【Author】 Wang Min The Fourth Hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院；

【摘要】 目的:探讨双腔球囊漂浮导管气道内置入治疗肺癌大咯血的护理方法,并评价其疗效及安全性。方法:在高流量吸氧,心电、心率、血压和血氧饱和度监测下,采用丝线固定将纤维支气管镜与双腔球囊飘浮导管并到一起经鼻腔插入气道,在吸引和冲洗气道内积血同时,循气道内血迹仔细寻找出血部位,在纤维支气管镜引导下将球囊导管推向出血的段或亚段支气管,球囊内注入生理盐水,使球囊膨胀至出血停止,记录生理盐水的用量,放松丝线,用纤维支气管镜吸尽气道残血,证实无出血后退出纤维支气管镜,保留球囊导管,并用T型胶布固定于鼻孔前。术后通过鼻侧导管开口抽吸球囊远端气道内积血和分泌物,如仍有新鲜血抽出,可用4℃含有肾上腺素的生理盐水进行冲洗,或注入凝血酶或立止血。每隔2—4h重复上述过程一次,直至无血性液体吸出。球囊置入期间均常规静脉应用垂体后叶素、立止血和止血合剂等药物治疗。观察24 h无鲜血抽出后拔出导管。在治疗过程中,术中如何与操作者的密切配合及采用怎样的导管固定方法,与操作的成败紧密相关;术后导管的护理,病情的观察是成功的关键．结果:7例患者均成功止血,无明显不良反应。结论:术前的充分准备、术中的密切配合、术后导管及病人的整体护理是确保本方法安全和疗效的重要基础。更多还原

【Abstract】 Objective: To the nursing method of treating massive hemoptysis by implanting double-lumen balloon floatation in airway and to evaluate its efficacy and the safety. Methods: breathe oxygen supervbe heart rate blood pressure and SPO2 insert the fibre bron-choscope and double-lumen balloon floatation catheter which fixed by silk suteare in the airway from nasut cavity allure and wash out the blood in the air way serch the bleeding point clirected by the fibre bronchoscope, put the catheter into bleeding bronchia inject 0.9% brine into the balloon, in order to prevent bleeding by the expand the balloon remember the dosage of the physiological saline, untie the silk suture, allure all the blood, pull out the fibre bronchoscope after insuring there was no bleeding. Reserve the catheter in the airway fixup catheter by the T shape adhesive plaster in front of the nares. Allure blood by the catheter, if there was new blood use 4℃ physiological saline with adrenalin to wash out the airway or inject thrombin. Do it in every 2-4 hours, until there was no blood. Using orcliouery hemostatie in vine. Put out the catheter if there was no new bleeding in twenty-four hours. During the operation, how to cooperation with the operator and the way of fixing the catheter all are important for the operation, observing the patients’ state of the illness and tend the catheter is the linchpin to finish the operation successfully. Results: All of 7 patients haemostasis and haven’ t any adverse effect, Conclusion: it is based on nursing successfully before, the cooperating during the operation and taking care of catheter and patients after the operation to ensure curative effect and safety.更多还原