Abstract:

This article is to summarize the postoperative nursing experience of a patient with tracheal rupture caused by automobile accident,who underwent tracheal rupture repair and was assisted by ECMO （extracorporeal membrane oxygenation）. Nursing points include as the following. The first is to strengthen airway management and prevent anastomosis from accidentally rupturing again. Secondly,to monitor oxygenation index to ensure the normal operation of ventilator and ECMO. The third one is to prevent and control infection to avoid difficult healing of cracks. Fourthly,systemic anticoagulation is monitored dynamically in order to reduce bleeding. Finally,analgesic sedative drugs are properly used,so as to reduce the occurrence of complications. Doctors successfully completed the tracheal rupture repair with the assistance of ECMO. After careful treatment and nursing care,the patient was disengaged from medical machines 5 days later,and was transferred to cardiothoracic surgery department 28 days later for further treatment. He recovered and was discharged from the hospital 53 days later.

Key words: Trachea, Closed, Trachea Fracture, Extracorporeal Membrane Oxygenation, Nursing Care

摘要：

总结1例车祸伤导致封闭性气管断裂患者在体外膜肺氧合（extracorporeal membrane oxygenation,ECMO）辅助下行气管断裂修补术的术后护理经验。护理要点：加强气道管理,防止吻合口再次意外断裂;关注氧合指数,确保呼吸机及ECMO正常运转;预防及控制感染,避免裂口难以愈合;动态监测凝血功能,减少出血;合理使用镇痛、镇静药物,减少并发症的发生。该患者在ECMO辅助下成功完成气管断裂修补术,经过精心治疗及护理,5 d后顺利脱机,28 d后转胸心外科进一步治疗,53 d后康复出院。

关键词: 气管, 封闭性, 气管断裂, 体外膜肺氧合, 护理