[1]王颐,鲜继淑.复杂颅颈交界区畸形伴困难气道的围手术期护理[J].中国临床神经外科杂志,2024,29(11):679-681.[doi:10.13798/j.issn.1009-153X.2024.11.009]
　WANG Yi,XIAN Ji-shu.Application of lean quality management in the prevention and treatment of intraoperative acquired pressure injuries[J].,2024,29(11):679-681.[doi:10.13798/j.issn.1009-153X.2024.11.009]
点击复制

复杂颅颈交界区畸形伴困难气道的围手术期护理()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年11期
页码:
679-681
栏目:
护理技术
出版日期:
2024-11-30

文章信息/Info

Title:
Application of lean quality management in the prevention and treatment of intraoperative acquired pressure injuries
文章编号:
1009-153X（2024）11-0679-03
作者:
王颐; 鲜继淑
400038重庆，陆军军医大学第一附属医院神经外科（王颐、鲜继淑）
Author(s):
WANG Yi;  XIAN Ji-shu
Department of Neurosurgery, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
关键词:
复杂颅颈交界区畸形; 困难气道; 围手术期护理
Keywords:
Complex cranio-cervical junction deformities;  Difficult airway;  Perioperative nursing
分类号:
R 743; R 473.6
DOI:
10.13798/j.issn.1009-153X.2024.11.009
文献标志码:
B
摘要:
目的 探讨复杂颅颈交界区畸形伴困难气道病人的围手术期护理。方法 总结1例复杂颅颈交界区畸形伴困难气道的围手术期护理体会，护理要点包括：基于3D模型的气道风险评估、建立气道护理团队制定护理方案、术前改善肺通气、口腔卫生护理、术后程序化撤机拔管、闭环式肺康复训练及吞咽评估训练。结果 经过积极治疗及个体化精细护理，顺利康复出院，出院时可携带颈托正常活动，无呼吸道相关症状。结论 复杂颅颈交界区畸形伴困难气道病人围手术期应加强气道管理，高质量的气道护理是保障顺利康复的关键。
Abstract:
Objective To explore the perioperative nursing strategies for patients with complex cranio-cervical junction deformities accompanied by difficult airways. Methods The perioperative nursing experience of a patient with complex cranio-cervical junction deformities and difficult airways was summarized. The key points of nursing encompassed: airway risk assessment based on 3D models, establishment of an airway care team and formulation of individualized care plans, preoperative improvement of pulmonary ventilation function, enhancement of oral hygiene management, postoperative programmed weaning and extubation, implementation of closed-loop pulmonary rehabilitation training, and assessment and training of swallowing function. Results Through active treatment and individualized meticulous care, the patient was successfully discharged from the hospital and was capable of wearing a cervical collar and moving normally without respiratory-related symptoms at discharge. Conclusion For patients with complex cranio-cervical junction deformities accompanied by difficult airways, perioperative airway management should be intensified. High-quality airway care is the key to ensuring the smooth recovery of patients.

参考文献/References:

[1] APFELBAUM JL, HAGBERG CA, CONNIS RT, et al. American Society of Anesthesiologists practice guidelines for management of the difficult airway [J]. Anesthesiology, 2022, 136(1): 31-81.
[2] MA WH, WANG Y, ZHONG M, et al. Investigation and analysis of difficult airways in medical institutions in China [J]. J Clin Anesthesiol, 2020, 36(4): 376-380. 马武华，王　勇， 钟　鸣，等. 中国医疗机构困难气道的调查与分析[J]. 临床麻醉学杂志，2020，36（4）：376-380.
[3] PANG D, THOMPSON DN. Embryology, classification, and surgical management of bony malformations of the craniovertebral junction [J]. Adv Tech Stand Neuros urg, 2014, 40: 19-109.
[4] OU YG, XU HT, CHEN ZB, et al. Curative effect of cervio-occipital fusion on complex craniocervical junction malformation [J]. Chin J Clin Neurosurg, 2018, 23(10): 644-647. 欧阳光，徐海涛，陈治标，等. 颈枕融合术治疗复杂颅颈交界区畸形的疗效分析[J]. 中国临床神经外科杂志，2018，23（10）：644-647.
[5] LIU ZH, JIANG YH, QU W, et al. MSCTA in preoperative evaluation of complex craniocervical junction malformation [J]. Chin J Med Imaging Technol, 2018, 34(2): 209-213. 刘正华，姜永宏，屈　巍，等. MSCTA术前评估复杂颅颈交界区畸形[J]. 中国医学影像技术，2018，34（2）：209-213.
[6] HE GJ, XUE XS, CHEN X, et al. Application of multimodal image fusion combined with multi-media 3D printing in surgery for complex cervical spinal dumbbell tumors [J]. J Clin Neurosurg, 2021, 18 (3): 275-279. 何光建，薛兴森，陈　欣，等. 多模态影像融合联合多介质3D打印在复杂颈椎管内外沟通性肿瘤手术中的应用[J]. 临床神经外科杂志，2021，18（3）：275-279.
[7] ROBBA C, POOLE D, MCNETT M, et al. Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus [J]. Intensive Care Med, 2020, 46(12): 2397-2410.
[8] CUI ZM, LIU J, ZHUANG X, et al. Best evidence summary for weaning from mechanical ventilation of adult patients in intensive care unit [J]. J Nurs, 2021, 28(6): 27-32. 崔朝妹，刘　静，庄　欣，等. ICU成人患者有创机械通气撤机的最佳证据总结[J]. 护理学报，2021，28（6）：27-32.

备注/Memo

备注/Memo:
（2023-07-26收稿，2024-11-13修回）
更新日期/Last Update: 2024-11-30