|
心脏术后病人早期行胸部物理治疗的临床观察 |
|
韩冬梅 李杏敏 杨秀珍
摘要:为了探讨早期行胸部物理治疗对心脏术后病人血气及心功能的影响,选择41例病人做自身对照观察。在拔除气管插管后10min行雾化吸入,随后叩背、排痰。结果:治疗结束后30min与治疗前相比,动脉血氧分压、氧饱和度明显升高,二氧化碳分压明显下降,而心率、血压只在治疗结束时有轻微的改变,治疗后30min与治疗前相比无差异。提示心脏术后病人可早期行胸部物理治疗,这对预防肺不张及肺部感染有重要意义。 关键词:心脏外科病人 胸部物理治疗 血气分析 心率 血压 中图分类号:R473.6 文献标识号:C 文章编号:1006-1584(1999)04-01 50-02
Clinical Observation on Post-operation of Cardiosurgery Patients to Start Chest Physiotherapy in Early Stage Han Dongmei,Li Xingmin,Yang Xiuzhen (No.251 Hospital of PLA,Hebei 075000 China)
Abstract:To probe into the effect on blood-gas analysis and hea r t function of post-operation cardiosurgery patients who received chest physiothe rapy in early stage,41 cases were selected and observed with self-control.Patien ts started to be given aerosol inhalation,back percussion and sputum aspiration 10 minutes after extraction of tracheal intubation.Results showed that 30 minute s after finished the treatment,both PaO2 and SaO2 of the patients elevated r emarkablely,and PCO2 decreased markedly compared to that before treatment.But heart rate(HR) and blood pressure(Bp)of the patients did not change significant ly.Denoted that cardiosurgery patients of post-operation may get chest physiothe rapy in early stage. Key words:Cardiosurgery patient Chest physiotherapy Blood-gas a nalysis Heart rate Blood pressure
体外循环下心内直视手术病人因体循环强迫肺灌注的原因,使肺泡张力降低,肺弹性减弱,肺顺应性下降,小气道及肺内分泌物增多[1]。气管切开术后病人由于气管插管刺激使呼吸道分泌物增多,即使肺功能正常(平均肺动脉压1.33 kPa~2.93 kPa)的病人术后肺通气、肺换气功能也下降,此为心脏外科ICU病人术后感染的相关因素。现通过早期胸部物理治疗,以预防肺不张及肺部感染的发生。
1 资料和方法 1.1 一般资料:选择我院择期术后ICU病人41例,男17例,女24例。年龄5岁~46岁,平均年龄39岁。其中房间隔缺损19例,室间隔缺损14例,法洛氏四联症5例,房室管畸形伴房间隔缺损3例。对于有肺部疾患、高血压病史、肺功能不良、肺动脉压大于6.93kPa及年龄小于5岁或大于46岁者暂不予观察。 1.2 方法: 1.2.1 术后病人在拔除气管插管后吸氧,2L/min~3L/min。10min后停止吸氧并将床头抬高45度,予庆大霉素8×104 U、糜蛋白酶5000U、地塞米松10mg、灭菌蒸馏水50ml雾化吸入20min,然后嘱病人坐起,叩背,并行有效的咳嗽、排痰。叩击频率1/s~2/s,叩击时间为10min,叩击力量为轻度震动病人胸壁,治疗毕重新吸氧。 1.2.2 在治疗前、治[1] [2] 下一页 上一个医学论文: 常用化疗药物致兔耳缘静脉损伤实验观察 下一个医学论文: 也谈护理文书的改革
|
|
|
|
|
|
|