Abstract:

This study aims to summarize the nursing care of a patient with a massive thoracic hematoma following the rupture of an acute Stanford Type B aortic dissection aneurysm. Key aspects of nursing care include：developing staged circulatory management protocols to maintain hemodynamic stability； implementing a stepwise weaning strategy while actively monitoring and managing extubation-related complications； dynamically balancing the risks of bleeding and coagulation to prevent rebleeding and thrombosis； establishing personalized follow-up programs led by ICU liaison nurses to ensure patient safety during the transition period. Through meticulous treatment and nursing care，the patient was successfully transferred to a general ward for further care on the 14th day after admission to the ICU and fully recovered，subsequently being discharged on the 21st postoperative day.

Key words: Aortic Dissection, Mediastinal Hematoma, Thermography, Mechanical Ventilator Weaning, Critical Care

摘要：

总结1例急性Stanford B型主动脉夹层动脉瘤破裂患者术后合并胸腔巨大血肿的护理。护理要点：分阶段制订循环管理措施，维持血流动力学稳定；实施阶梯式撤机策略，积极评估拔管并发症；动态评估出凝血风险，预防再出血及血栓形成；实施ICU护士主导的个性化随访，保障患者过渡期安全。经过精心治疗与护理，患者入住ICU第14天转入普通病房继续治疗，术后第21天康复出院。

关键词: 主动脉夹层, 胸腔血肿, 热成像技术, 机械通气撤机, 重症护理