Search

This paper summarized the rehabilitation nursing management of a patient with severe traumatic brain injury complicated with multiple rupture of thoracic-abdominal organs based on the concept of enhanced recovery after surgery. Based on the enhanced recovery after surgery, a multidisciplinary team for rehabilitation management was set up. Comprehensive treatment and nursing interventions including postoperative management of intracranial pressure, management of traumatic liver injuries, exercise rehabilitation, postoperative thromboembolism prevention, enteral nutrition support and management of antiepileptic drug were carried out to prevent postoperative complications and improve the rehabilitation. (本文总结1例基于加速康复外科(ERAS)理念的重型颅脑创伤伴肝脾破裂、肋骨骨折、肺、肾挫裂伤危重症患者的康复护理经验。基于ERAS理念, 组建多学科康复管理团队, 制定全面的康复治疗方案, 包括术后颅内压管理、创伤性肝损伤康复、运动康复管理、术后血栓预防管理、术后肠内营养管理、术后抗癫痫等详细的康复方案, 有效预防相关并发症, 促进患者康复。)

目的 分析创伤患者早期发生急性呼吸窘迫综合征(ARDS)的危险因素。方法 回顾性分析177例创伤继发ARDS患者的临床资料,根据创伤后发生ARDS时间分为早发ARDS组(伤后发生ARDS时间<48 h)、迟发ARDS组(伤后发生ARDS时间≥48 h)。收集患者的性别、年龄、病史、创伤情况、检查检验结果、疾病转归等数据,比较两组之间的差异,采用Logistic回归分析创伤患者早期发生ARDS的危险因素。结果 177例创伤继发ARDS患者中早发ARDS组55例、迟发ARDS组122例。早发ARDS组、迟发ARDS组病死率分别为47. 27%(26/55)、22. 13%(27/122),两组相比P=0. 001。Logistic回归分析结果显示:钝性伤(OR=2. 343,P=0. 035)、APACHEⅡ(OR=1. 812,P=0. 005)、肺挫伤(OR=3. 474,P=0. 001)、急诊剖腹探查手术(OR=2. 562,P=0. 023)是创伤患者早期发生ARDS的独立危险因素。结论 创伤后早期发生的ARDS相关危险因素为钝性伤、高APACHEⅡ、肺挫伤、急诊剖腹探查手术,可在临床早期给予积极干预,改善患者预后。 [ABSTRACT FROM AUTHOR]