Easter A
University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Ark., USA.
Am J Crit Care. 2001 Sep;10(5):320-7; quiz 328-9.
Multiple rib fractures in trauma patients are associated with significant morbidity and mortality. Delayed morbidity for patients with rib fractures is often a result of hypoventilation leading to atelectasis, pneumonia, and respiratory failure. Pain management was first recognized as an important factor in preventing complications in these patients. Later, management of the respiratory system became more widely recognized as a major factor in patients' care. It is now known that patients with multiple rib fractures benefit most from adequate pain control, rapid mobilization, and meticulous respiratory care to prevent complications. A protocol based on a synthesis of the existing literature is developed. Development of such a protocol for decisions about rapid mobilization, respiratory support, and pain management is the first step in testing the hypothesis that these interventions will decrease the length of patients' stay in intensive care units.
创伤患者的多根肋骨骨折与显著的发病率和死亡率相关。肋骨骨折患者的延迟发病通常是由于通气不足导致肺不张、肺炎和呼吸衰竭。疼痛管理最初被认为是预防这些患者并发症的一个重要因素。后来，呼吸系统管理作为患者护理中的一个主要因素得到了更广泛的认可。现在已知，多根肋骨骨折的患者从充分的疼痛控制、快速活动以及精心的呼吸护理以预防并发症中获益最大。基于现有文献的综合制定了一个方案。制定这样一个关于快速活动、呼吸支持和疼痛管理决策的方案是检验这些干预措施将缩短患者在重症监护病房住院时间这一假设的第一步。
