Blood accumulates in the pleural cavity, known as hemothorax. We currently have many patients suffering from chest pain, hemothorax, pneumothorax and other diseases. There are many people seeking medical advice, and if not treated in a timely manner, it can also lead to many other diseases. To treat a disease, it is necessary to understand the cause and treat it accordingly to avoid danger. Let's learn together!
1、 The etiology of hemothorax
There are multiple causes of hemothorax, and the four most common ones in clinical practice are as follows.
1. Traumatic hemothorax, caused by car accidents, falls from heights, and impacts on the chest, can lead to rib fractures, damage to blood vessels between ribs, damage to large blood vessels in the chest cavity, or lung contusions and lacerations, all of which can cause bleeding in the chest cavity and result in hemothorax.
2. Malignant tumors can cause bloody pleural effusion, such as lung cancer, esophageal cancer, pleural malignancies, etc. Tumor invasion of normal cells causes bloody exudate.
3. Thoracic infectious diseases, such as pneumonia, exude from capillaries and cause bloody fluid.
4. Spontaneous hemothorax. Thoracic aortic rupture.
2、 The clinical manifestations of hemothorax can be divided into three types based on the amount of hemothorax: 1. Small amount hemothorax, with a hemothorax volume of less than 500ml and no obvious clinical symptoms or signs;
2. Patients with moderate hemothorax and pleural volume ranging from 500ml to 1500ml may experience early symptoms of hemorrhagic shock, such as increased heart rate, decreased blood pressure, pale complexion, difficulty breathing, weakened respiratory sounds due to lung injury, and voiced percussion sounds;
3. Massive hemothorax with pleural effusion exceeding 1500ml, severe respiratory and circulatory symptoms, obvious shock symptoms, heart rate greater than 120 beats per minute, decreased blood pressure, pale or bruised complexion, thirst, cold limbs, disappearance of respiratory sounds in the affected lung, and tracheal displacement.
3、 Common nursing measures for hemothorax
1. Follow the general nursing routine for thoracic surgery patients.
2. Preoperative nursing
(1) Regularly monitor the patient's consciousness, blood pressure, heart rate, pulse, respiratory rate and amplitude, and changes in blood oxygen saturation. If any abnormalities are found, immediately notify the doctor and prepare for immediate rescue. (2) Open the venous channel, match blood, understand the hemoglobin test results, and if necessary, follow the doctor's advice to administer blood transfusion. (3) Patients with progressive bleeding should prepare for thoracotomy to stop bleeding according to medical advice.
3. Postoperative nursing
(1) Follow the nursing points for patients under general anesthesia and lie in a supine position when awake. (2) Regularly monitor changes in blood pressure, heart rate, pulse, and breathing, and promptly notify doctors if any abnormalities are detected. (3) To rest in bed, do not walk underground casually. Continuously inhale oxygen, reduce labor, control primary lung diseases, or deal with external factors that cause hemothorax. (4) Maintain unobstructed closed chest drainage. (5) For patients with hemothorax complicated with infection, strict aseptic dressing should be applied locally during wound care to prevent infection of the drainage tube and surrounding soft tissues. If the surrounding soft tissues are infected, it can lead to pleural hemorrhage and trigger infection, resulting in empyema. (6) Follow the doctor's advice for intravenous fluid replacement, administer antibiotics, and maintain water, electrolyte, and acid-base balance. (7) Encourage patients to consume a high calorie, high vitamin, and easily digestible diet. (8) Vigorous exercise should be avoided, as hemothorax usually requires early closed thoracic puncture drainage. Therefore, the drainage tube and skin should be properly fixed to prevent the drainage tube from falling off during movement. (9) The position of the drainage bag or drainage bottle after placement should be too low or too high. If it is too high, it can cause liquid reflux, prevent the drainage bottle from tipping over, and cause air leakage. These are common nursing measures we take.
But when caring for patients with hemothorax, we also need to pay attention to regularly observing the effectiveness of our treatment, because hemothorax patients will use hemostatic drugs. If these drugs are used for a long time, they may cause complications such as high blood pressure, which requires us to adjust the effectiveness of our treatment according to the condition.