摘要
目的总结颅眶穿透伤合并创伤性湿肺的术前急救及围手术期护理经验。方法回顾性分析1例颅眶穿透伤合并创伤性湿肺的临床资料,在全麻下行眼眶、颅内异物取出术+右眼球摘除术+右眼眶及颅骨内清创术+颅底重建术+右边侧颞肌下去骨瓣减压术,术后抗感染、抗癫痫并给予精心护理。结果病人术后逐步恢复,GCS评分15分,生命体征平稳,头部伤口一期愈合。右眼摘除及右眼眶清创术后伤口愈合良好,右侧上眼睑仍轻微水肿,左眼视力正常。双肺呼吸音清,未闻及干、湿性啰音。四肢肌力5级,肌张力正常。结论及时而彻底的颅脑清创术加优质的护理可以明显降低并发症发生率,保证医疗护理质量,提高患者的生存质量,促进患者早日康复。
Objective To summarize the experience in perioperatively nursing patient with penetrating cranio-orbital injury complicated with traumatic wet lung.Methods The clinical data of a patient with penetrating cranio-orbital injury complicated with traumatic wet lung was analyzed retrospectively.Under the general anesthesia,the intraorbital and intracranial foreign body removal,right eyeball enucleation,right orbital and intracranial debridement,skull base reconstruction,and right subtemporal decompression were performed in the patient.Anti-infection,anti-epilepsy and meticulous nursing were given to the patient after the surgery.Results The patient recovered gradually after the operation.The GCS score was 15 patients.The vital signs were stable and the head wound healed by the first intention.The wound healed well after right eyeball enucleation and orbital debridement.The right upper eyelid was slightly edematous and the vision of the left eye was normal.Breathing sound was normal.No dry and wet rales were heard.Muscle strength was level 5 and muscle tension was normal.Conclusions Timely and thorough craniocerebral debridement combined with good nursing can significantly reduce the incidence of complications,improve the quality of life of the patient and promote early recovery in the patient with penetrating cranio-orbital injury complicated with traumatic wet lung.
作者
王鹿婷
王艳
王艳新
吉润芷
陈颖
吴秋兰
陈银银
钟孝益
WANG Lu-ting;WANG Yan;WANG Yan-xin;JI Run-zhi;CHEN Ying;Wu Qiu-lan;CHEN Yin-yin;ZHONG Xiao-yi(Department of Neurosurgery,The First Affiliated Hospital,Hainan Medical College,Haikou 570102,China)
出处
《中国临床神经外科杂志》
2019年第2期112-114,共3页
Chinese Journal of Clinical Neurosurgery
关键词
颅眶穿透伤
术前急救
护理
Penetrating cranio-orbital injury
Traumatic wet lung
Preoperative first aid
Perioperative
Nursing
