About two cases of strangulating intestinal obstruction complicated by shock first aid nursing(两例遏制肠梗阻并发休克的急救护理)

AbouttwocasesofstrangulatingintestinalobstructioncomplicatedbyshockfirstaidnursingPaperNetwork:[Definitionofstrangulatingintestinalobstruction]intestinalcontentscannotrunsmoothlythroughtheintestinaltract,knownasintestinalobstruction.Strangulatedbowelobstructionmeanstheobstructionaccompaniedbyimpairedbloodsupply,maybeduetomesentericvascularcompressioncausedbythrombosisorembolism.[Strangulatingintestinalobstructioninthedifferentialdiagnosis]1episodesofacuteabdominalpain,persistentpainisstarting,orarestillongoingbetweentheincreaseinparoxysmalpain,hyperactivebowelsoundsmaysometimesappearlowbackpain,severeandfrequentvomitingappearearly.(2)rapidprogressionofthedisease,earlyshock,1anti-shocktreatmentnoobviousimprovement.3significantlyincreasedperitonealirritationtemperaturepulsetoacceleratewhitebloodcellcountincreased.4asymmetricbloating,abdominaltendernesslocalizedupliftorreachthemass.5outoffluiddecompressionvomit,bloodyanaldischarges,orabdominalpunctureoutofbloodyfluid.6Theactivenon-surgicaltreatmentofthesymptomsdidnotimprove7seetheisolatedabdominalX-rayexamination,prominentswellingoftheintestinalloop,thelocationdoesnotchangeovertime,orfalsetumor-likeshadow,orintestinalgapwidened,suggestingascites.Ourdepartmentin2011April-Mayhasrescuedtwocasesofstrangulatingintestinalobstruction,acuteperitonitis,toxicshockpatients,familymembersofpatientsabandontreatmenteventuallydischarged.NowRescueandNursingreportedasfollows.1CaseInformationCase1:malepatients.762yearsold.For‘abdominalpain’tohospitalout-patienttreatment,collapsedduringaninspection,rushedtotheemergencyroomfortreatment.Checkthepatientconscious,pale,coldextremities,cyanosis.P138-258times/min,R24times/min,BP77/43mmHg,SPO285%.ECGdiagnosis:supraventriculartachycardia.Initialdiagnosis:shock.Togiveoxygen,ECGmonitoring,theexpansionstep,anti-arrhythmic,correctacidpoisoning,infectioncontrolandotheranti-inflammatorytreatment,whileadmissionstomedicalexaminationfoundnosignificantabdominaltenderness,yourgeneralsurgeryconsultation,combinedwithX-rayexaminationresults,adiagnosisof‘strangulatingintestinalobstructioncomplicatedbyshock.’bytheactiveanti-shocktherapy,bloodpressureroseto110/59mmHg,HR130-150times/min,SPO295%.Butthefamiliestogiveupthechanceofoperation,therescueofmorethanthreehoursafterwithdrawaloftreatment,leftthehospital.Case2:malepatients.78yearsold.Patientswithbloodinthestooltendays,thewayintoourhospitalcardiopulmonaryarrest.Rushedtotheemergencyroom,3check:patientswithbilateralfixeddilatedpupils,nobreathing,noheartbeat.CardiopulmonaryresuscitationimmediatelyPleaseanesthesiaendotrachealintubation,balloon-assistedbreathing,establishingintravenousaccess,prescribeduseofepinephrine,NAHCO3otherdrugsstimulatetheheart,correctingacidexpansion,icecapstopreventcerebraledemaintherescueafter15minutes,thepatientrecoveredspontaneousbreathingandheartbeatBP153/90mmhg,HR88times/min,SPO295%.thentransferredtotheICUward,doctorexaminationfoundabdominaldistension,withinguinalhernia,yourgeneralsurgeryconsultation,adiagnosisof‘strangulatingintestinalobstruction,’explaintothefamilyillness,thefamilyabandonedthetreatment,automaticallydischarged.Theinvestigationofthesetwopatientsweredischargedthedayofdeath.2rescueexperience2.1withtherescueTheincidenceofacutepatientsoftenshowintotheemergencyroomwithshockintherescueprocess,asanurseshoulddo:activelycoopera...

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