1.改善通气维护呼吸功能
\n及时清除气管内分泌物，保持呼吸道通畅，严密观察呼吸道情况，监测呼吸机给氧的真正效果；定时做血气分析；了解肺功能、保持血氧饱和度在98%以上；做呼吸管理、气管内吸痰，动作轻而短暂，每次不能超过15 s。吸痰前后给高浓度氧气。避免低氧血症进一步使用颅内压增高。
\n2. 做好基础护理
\n（1）患者体位、抬高床头15°～30°，以利于静脉回流，减轻肺水肿，帮助患者每2 h翻身1次，按摩皮肤受压处防褥疮，翻身时与翻身后使患者头部身躯体保持一条直线，以便维持静脉回流、降低颅内压。（2）保持室内安静谢绝探视、减轻陪护、保持患者充足睡眠、避免颅内压波动。（3）输液管理、严格控制液体入量及早期限制钠盐的摄入，根据患者的生命体征、尿量及颅内压决定补液量，以保持尿量于正常范围为适度。（4）饮食管理：患者2次手术、伤口修复需要加强营养，气管切开会失大量的水分，患者吞咽困难导致摄入不足。高热消耗大量的水分、热量。脱水剂的使用易造成电解质紊乱。我们采取早期管饲高蛋白、高热量、高维生素、营养丰富易消化的流质食物；同时控制进水量及食盐量。
\n3. 积极防治并发症
\n（1）肺部感染：将患者安置在单人房间、保持室内空气流通、清洁温、湿度适宜。控制出入人次。定时做空气消毒，每日2次，经常更换体位并轻轻叩击背部及时而科学地吸痰，适当取半坐位防止误吸，严格无菌操作，做好气管节开和呼吸机治疗的管理，气管套管每日清洗消毒2次，及时留取痰标本做细菌培养及药敏试验，给予营养支持，提高机体抵抗力；（2）电解质紊乱：合理补液，记录24 h出入量，定时监测尿比重、尿钠，监测血生化。（3）高热：给予患者头部冰枕、腋窝腹股沟等大血管表浅处置冰袋，有效控制高热、降低脑细胞代谢和耗氧量，增强脑细胞对缺氧耐受力，有助于防止和减轻脑水肿：补充水分和营养，增加患者抵抗力，促进机体早日康复。
\n出院指导
\n做好健康教育宣教，嘱加强营养，饮食宜高热量、高维生素、高蛋白，适当运动，不宜过度疲劳，积极预防感冒，保持良好心态，并定期来院复查。
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更新时间：2012-08-01 15:39:09 | 文章来源：有问必答健康社区
2004年3月2日《内科学年鉴》（annals of internal \nmedicine）上的一项再次分析表明，低潮气量通气对急性肺损伤的超重和肥胖病人的益处与对正常体重者相似。
“尽管成人的肥胖很流行，但超重对重症病人后果的影响还没得到很好研究”，美国科罗拉多大学的奥伯利恩（james m. \no''''brien）和国立心、肺和血液研究所（nhlbi）的同行写道，“有人认为高潮气量通气对需要呼吸机的肥胖病人有益”。
\n他们检查了10家医疗中心招募来参加随机对照试验的902名急性肺损伤病人的资料：这些试验指定病人或接受较高（12ml/kg）或较低潮气量（6ml/kg）通气，部分人还使用了酮康唑、己酮可可碱或安慰剂。与体重正常的病人相比，肥胖病人肺损伤如创伤的间接原因更多。试验开始前，超重和肥胖病人因为设置的潮气量较高，气道平台压力更高。结果表明，体重与调整死亡危险增加、实现停用呼吸机或不用呼吸机的时间无关。
“超重和肥胖急性肺损伤病人的后果与体重指数（body mass \nindex，bmi）正常者相似”，作者写道，“这表明低潮气量对他们都有益”。“医生不应想当然地认为肥胖病人的状况差于正常病人”，他们说，但“将来还要研究对其它重症病人，过重是否增加了后果不良的危险”。
血胸疾病并不是人们想象的那么可怕，只要我们患者能够积极的进行治疗，相信疾病是可以得到很快恢复的，而且现在医疗技术水平发达，这个疾病是可以通过手术进行治疗的，但是在手术的前后要做好护理事项，下面我们护体来看一下。
\n一、术前护理
\n1、胸腔闭式引流的观察和护理：应密切观察生命体征变化。对于持续引流的患者，应保持引流装置密闭无菌，每日观察引流量并记录，每日在无菌操作下更换引流瓶，经常挤压引流管，避免受压、扭曲。
\n术后半卧位，鼓励患者深呼吸及有效咳嗽，保持引流通畅，注意观察引流管的水柱波动情况，告知患者任何情况下引流瓶不可高于胸部;指导病人带管下床活动，妥善携带引流瓶，保持密封系统，不需夹管。
\n2、饮食护理：患者入院后即告知患者及家属低脂甚至无脂饮食，术前2周开始禁食，应用周围静脉高价营养。
\n3、周围静脉高价营养的护理：每日选择粗直的手臂静脉进行穿刺，同一根血管不得连续使用2次以上，每天先补充液体，待全天补液量还剩500ml时，以同一静脉通道以20滴/min速度输注，输完后，再输剩下的500ml，葡萄糖或复方氨基酸液，滴注脂肪乳的同，输液肢体局部放置水温在72～74℃的热水袋，外加干毛巾包裹，直至输液全部结束，可以防止或减轻周围静脉硬化，输入过程中经常巡视病房，严防药液渗漏皮下，导致组织坏死。
\n4、心理护理：对于在就医过程出现不配合医生的行为的患者，医生应主动讲解禁食的重要性和疾病相关知识，争取配合治疗，另一方面与医生沟通，经全科人员高度重视，进行术前讨论，制定周密的医疗和护理计划，消除患者焦虑心理，使其在最佳心理状态下接受治疗。
\n5、术前宣教：向患者介绍术前需做哪些准备，术后可能出现的不适，需如何配合等，如术前预防呼吸道感染，练习床上大小便，学会深呼吸和做有效咳嗽，术后离床活动的时间、活动量、活动意义，以及预防术后并发症。
\n二、术后护理
\n1、胸腔闭式引流的观察及护理术后观察胸腔闭式引流液的颜色、量，患者取半卧位，鼓励患者有效咳嗽，做深呼吸，协助拍背，经常挤压引流管，保持引流通畅，带管下床活动。
\n2、饮食护理：术后患者禁食，应用周围静脉高价营养两周，开始无脂饮食，1周后改为低脂饮食。
\n3、生命体征的观察。
\n通过阅读上面文章内容，我们能够了解到血胸患者手术前后的护理事项，希望大家要重视这些，这些护理事项做到了，能够有利于疾病的缓解和恢复，对于手术的成功也是起着至关重要作用的，希望我们患者能够早日恢复健康。
\n","barId":"1686","topicTypeId":"3","topicThemeId":"1022","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1789,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1486701414899,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1486701414894,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"b1a5ca4ddfad11e6a61c00163e04584d","isDel":0,"createAt":1484984778320,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"小海螺","password":"yiren2921","level":0,"nickName":"小海螺78","realName":null,"signName":"开心每一天","head":"http://01luntan.com/ly_img/1484985295689.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"2276635444@qq.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110108","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"1821","isDel":0,"createAt":1486701275538,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"气胸的常见护理方法有哪些","content":"
气胸也可以说是一种呼吸道疾病，使患者呼吸急促、胸痛、胸闷，影响我们的正常工作和生活，那么我们应该注意及时的进行治疗，除此之外，还要做好日常生活中的护理，避免一些并发症的出现，下面就气胸这种疾病的护理方法给大家做一下总结：
\n一、 执行呼吸系统疾病一般常规。
\n二、绝对卧床休息。取半卧位或坐位，避免过多的搬动病人和不必要的活动。咳嗽时不要用力，以免自发性气胸反复发生。保持大便通畅。
\n三、呼吸急促或紫绀时 ，应急速给予氧气吸入。
\n四、配合医师进行胸腔抽气，抽气时，病人避免过度用力和剧咳，可给予镇静、止痛、镇咳、药物。以免咳嗽用力而促使自发性气胸复发。
\n\n
气胸病人的护理方法有哪些
\n1、如果是刚做完手术不到半年的，最好是好好养病，不要做剧烈运动，最重要的是不要做憋气的事，例如跑步也不能太喘了，最好小跑，散步。
\n2、饮食方面，多吃水果(苹果，梨什么的)，蔬菜(青菜、胡萝卜等)，最好每天能吃一个鸡蛋，喝点牛奶，少吃红肉类，多吃鱼肉类;
\n3、手术后半年内最好不要去旅游，静心修养，大家还是在各方面都多注意些好，完全康复后就没啥大事了;
\n4、每3个月或者半年去复查一次，如果身体遇到不适则需及时去复查，也不要太过勤奋的往医院跑，现在医院的医生也没几个好东西，能多挣你的钱就尽量多挣，只要对你的身体没有啥影响，例如给你多开些什么中药啊，吃不吃都无所谓的。
\n以上就是气胸出现后的一些护理方法，希望以上对您有帮助，气胸的危害非常大，所以大家要重视起来，提醒人们在发现了疾病更是要积极来做好正确的护理，多方面了解之后在及时治疗。
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脓胸疾病出现以后，患者的体温一般都会升高，让患者的一些生命体征发生变化，因此这种疾病需要很的护理方式，这样才能够让疾病得到更快的康复，也可以避免病情恶化，接下来让专家介绍一下，脓胸患者的护理方式有哪些。
\n（一） 保持引流系统密闭
\n使用前应仔细检查引流装置的密闭性；水封瓶长玻璃管没入水中3-4CM，并始终保持直立；胸壁引流管口周围用油纱布包盖严密；更换引流瓶时，应双重钳夹引流管，以防空气进入胸膜腔。
\n（二） 保持引流通畅
\n观察水柱波动情况（正常上下波动4-6CM），定时挤压引流管，防止其受压、折曲、阻塞；若有阻塞，应报告医生，并协助处理。
\n（三） 妥善固定
\n将胸腔引流管用别针固定在床单上，保持足够的长度，以免翻身时牵拉导管引起疼痛或使导管脱出。
\n（四） 观察引流液的量及性状
\n若引流量多，且色鲜红，提示有活动性出血，应报告医生。
\n（五） 每日更换引流瓶一次，引流瓶内需放置一定量的无菌生理盐水。
\n脓胸患者的治疗还需要我们不断地总结临床知识，因为只有我们总结了脓胸的治疗我们才会深入的了解患者，不断地给予脓胸患者一定的护理和治疗，再者还需要及时的观察我们的治疗和护理的效果，及时的给予疾病的评估和诊断。
\n通过以上的介绍现在大家已经清楚的了解了脓胸患者的护理方式有哪些了吧。脓胸疾病出现以后，经常会引发肺炎，脓胸疾病就是肺炎的一些前期表现症状，因此及时的治好脓胸疾病对于肺炎的预防， 可以起到非常有效的效果，专家在文章中对于脓胸疾病的治疗方式，给出了详细的介绍，希望能对患者的病情起到，很好的帮助。
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