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新型冠状病毒肺炎老年患者双肺移植术中护理:两例病例报告

Intraoperative care of elderly patients with COVID-19 undergoing double lung transplantation: Two case reports.

作者信息

Wu Qi, Wang Ying, Chen Han-Qian, Pan Hui

机构信息

Operating Room, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.

Department of Lung Transplantation Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.

出版信息

World J Clin Cases. 2020 Nov 26;8(22):5765-5772. doi: 10.12998/wjcc.v8.i22.5765.

Abstract

BACKGROUND

Lung transplantation is considered an effective method for treating patients with end-stage coronavirus disease 2019 (COVID-19). The nurses play a pivotal role in lung transplantation for COVID-19 patients.

CASE SUMMARY

Two elderly patients were admitted to the emergency department due to cough, and the nucleic acid test was positive. The patients were preliminarily diagnosed with COVID-19. The chest computed tomography scan revealed massive lung consolidation, and the patients did not improve after treatment with antiviral drugs, glucocorticoids, antibiotics, and other drugs. Under the support of pure oxygen in extracorporeal membrane oxygenation, the patients' oxygen levels were still poor, indicating that they were in the terminal stage of viral pneumonia. The patients underwent double-lung transplantation and received intraoperative care. The extracorporeal membrane oxygenation device was removed within a week of the surgical procedure, and the respiratory circulation of the patients were stabilized.

CONCLUSION

High-quality care for COVID-19 patients undergoing lung transplantation ensures patient safety during operation while protecting the safety of the medical staff.

摘要

背景

肺移植被认为是治疗终末期2019冠状病毒病(COVID-19)患者的有效方法。护士在COVID-19患者的肺移植中起着关键作用。

病例摘要

两名老年患者因咳嗽入住急诊科,核酸检测呈阳性。患者被初步诊断为COVID-19。胸部计算机断层扫描显示肺部大量实变,患者在接受抗病毒药物、糖皮质激素、抗生素等药物治疗后病情未改善。在体外膜肺氧合纯氧支持下,患者氧合水平仍较差,提示处于病毒性肺炎终末期。患者接受了双肺移植并接受了术中护理。体外膜肺氧合装置在手术一周内拆除,患者呼吸循环稳定。

结论

对接受肺移植的COVID-19患者进行高质量护理可确保患者手术期间的安全,同时保护医护人员的安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/535b/7716330/2061559b0887/WJCC-8-5765-g001.jpg

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