CAJ | 학술논문

目的：防治严重胸部开放性损伤引起气胸、血胸致呼吸困难，脏器或大血管损伤的大出血休克及术后并发症。方法对2012年1月至2013年1月，58例此类病人术前保持呼吸道通畅，快速扩容，心理护理；术中安全措施实施、操作技巧的应用；术后鼓励病人咳嗽、咳痰、深呼吸，有效拍背刺激咳嗽排痰，保持引流通畅，指导病人早期下床活动，预防感染及肺不张。结果有1例主动脉弓破裂伴严重失血性休克时间过长抢救无效死亡，其余病人安全度过了围手术期。结论早期诊断，抗休克，迅速做好必需的术前准备，赢得手术时机，尽早进行伤口的封闭，保持呼吸道通畅，术中安全措施的实施，操作技巧的应用，鼓励病人早期下床活动，合理营养，观察引流管及伤口的情况，术后抗生素的应用，是挽救病人的生命、防止并发症，促进病人康复的关键。
목적：방치엄중흉부개방성손상인기기흉、혈흉치호흡곤난，장기혹대혈관손상적대출혈휴극급술후병발증。방법대2012년1월지2013년1월，58례차류병인술전보지호흡도통창，쾌속확용，심리호리；술중안전조시실시、조작기교적응용；술후고려병인해수、해담、심호흡，유효박배자격해수배담，보지인류통창，지도병인조기하상활동，예방감염급폐불장。결과유1례주동맥궁파렬반엄중실혈성휴극시간과장창구무효사망，기여병인안전도과료위수술기。결론조기진단，항휴극，신속주호필수적술전준비，영득수술시궤，진조진행상구적봉폐，보지호흡도통창，술중안전조시적실시，조작기교적응용，고려병인조기하상활동，합리영양，관찰인류관급상구적정황，술후항생소적응용，시만구병인적생명、방지병발증，촉진병인강복적관건。
Objective Prevention and treatment of severe open pneumothorax,hemothorax caused the breath difficulty caused by injury of chest,organ or vascular injury after hemorrhage shock and postoperative complications.Methods From 2012 to January to 2013 January,58 cases of such patients to maintain airway patency,pre-operative rapid expansion,psychological nursing;application of safety measures during implementation ,operation skills;postoperative encourage patients to cough,expec-toration,deep breathing,effective back stimulus cough and expectoration,keep smooth drainage,guiding patients early ambulation,prevention of infection and atelectasis. Results There were 1 cases of aortic rupture with serious hemorrhagic shock time long rescue invalid death ,the other patient safety through peri operation period .Conclu-sion Early diagnosis,anti shock,quickly prepared necessary preoperative,win the operation time,early closure of the wound,to maintain airway patency,the implementa-tion of safety measures in operation,application skills,encourage patients to early ambulation,reasonable nutrition,observe drainage tube and the wound,postoperative ap-plication of antibiotics,is to save the patient's life,prevent the complications,and promote the rehabilitation of patients.