胸外伤（49页）.pptVIP

Oxygenation Oxygenation is the prime [pra?m早期的concern [k?ns??n关系and the mode of delivery will range from nasal [k?ns??n鼻骨 cannula[k?nj?l?] 插管 through face masks and non-invasive [?nve?s?v有创 ventilatory[,vent?le??(?)n]通气may be needed for major air leaks and special techniques are used in acuter respiratory[r??sp?r?tri]呼吸的 distress syndrome [s?ndr??m] 并发症 (ARDS), a common complication of multiple injuries.氧气在胸部损伤病人中的应用。 Pain relief Pain relief is the dominant [d?m?n?nt]显著 issue for patients with chest wall in- juries, incisions [?ns??(?)n]切口 or chest drains. The pain may be minimal 最小的if one remains stationary and does not breathe deeply or cough. This, however, results in sputum [spju?t?m痰液retention [r?ten?(?)n] 滞留atelectasis [,?t?lekt?s?s肺不张, pneumonia and the need to escalate [esk?le?t逐步提高 care.止痛在胸部损伤治疗中的作用。 The degree of pain should be anticipated [esk?le?t考虑 and treated prophylactically预防; all patients with chest injury or a chest drain will require regular opioid [??p???d]阿片类 analgesia[,?n(?)ld?i?z??止痛, rather than ‘as required’.如何采取止痛治疗。 Clearance of secretions Retention of bronchial [br??k??l]支气管 secretions is what causes pneumonia [nju?m??n??]肺炎, respiratory failure and contributes to ARDS. Adequate pain relief, physiotherapy [,f?z??(?)θer?p?]物理治疗 and nebulized [nebj?la?z]雾化bronchodilators 支气管扩张药(particularly in Smokers and COPD patients) is usually enough for most patients. A good cough clears secretions, expands the lungs, expelsa pneumothorax through the chest drain and obviates 排除the need for chest drain suction. [s?k?(?)n]吸保持气道通畅，清除气道分泌物。 Prophylactic 预防性[,pr?f?l?kt?k]use in high-risk patients will prevent respiratory complications.并发症 In the ventilated patient, failure of re-expansion 复张of lung segments肺段 by routine suction should prompt ?exible[fleks?b(?)l] bronchoscopy. [br??k?sk?pi]支气管镜预防性治疗。 Chest drain management The main operative intervention in blunt chest trauma is the insertion of chest drains of suitable size into the right positi