胸外科术后并发胸腔内出血的观察迟疑与护理(改1)(国外英文资料).docVIP

胸外科术后并发胸腔内出血的观察与护理(改1)(国外英文资料) The observation and nursing of internal hemorrhage after thoracic surgery Large hemorrhage in the chest cavity is a serious complication of thoracic surgery, such as not finding the right treatment in time, can cause hemorrhagic shock and endanger life. Observe the changes of vital signs After the operation, the patient was given a nursing room, special care, 5 ~ 10 minutes to measure blood pressure, pulse, and breathing 1 times. Dynamic monitoring of blood pressure and pulse changes is of great significance to estimate the amount of blood, to determine the disease and to guide the treatment. If the bleeding is not more than 10% of the blood volume ( 400 ml), the body through the compensatory function, the sympathetic nervous excitement, catecholamine release, systolic blood pressure can be maintained or close to normal, but diastolic blood pressure, pulse pressure difference narrowed, rhythm of the heart, breathing accelerated; When the bleeding by more than 20% of the blood volume pulse faster, pressing of arteries and veins is falling, pulse increases faster in front of the drop in blood pressure, can reflect the early bleeding volume changes. Such as pulse is over 120 times/min, systolic blood pressure is lower than 12 kPa, pulse pressure difference is less than 2.6 kPa, patients pale complexion, cold limbs, indifferent to fidget or expression, and as the shock of the early performance, should be vigilant the presence of abdominal cavity hemorrhage. To observe the changes of the fluid in the chest Clear thoracic hemorrhage is the key to determining conservative treatment or reoperation. Such as color, drainage of liquid from pink to red, led traffic 150 ml/h, or change positions after suddenly there is a lot of blood lead, drainage of liquid temperature is higher, the drainage tube sample fog droplets or coagulation clot, measuring liquid drainage of hemoglobin and hemoglobin value is close to the same time end, blood pressure dr