一例血栓闭塞性脉管炎并糖尿病足患者护理体会.docVIP

一例血栓闭塞性脉管炎并糖尿病足患者护理体会【摘要】 血栓闭塞性脉管炎(TAO)是外科难治性疾病，是常见的周围血管疾病，病变呈周期性发作，病程长,痛苦大，致残率高，至今尚无理想的治疗、护理方案，重者难免截肢致残。血栓闭塞性脉管炎患者合并糖尿病足更是增添了治疗和护理的难度［1-4］，为提高患者生活质量，避免患者截肢致残，减低患者医疗费用，本院于2006年5月为一例拒绝外科手术治疗的左髂总、左髂内外动脉完全性闭塞性脉管炎伴糖尿病足患者实施了加强伤口皮肤护理,全身营养支持,积极治疗基础疾病的个案护理，护理方案获得成功，患者伤口在12周内痊愈出院，避免截肢致残。对其进行了为期2年的定期随访。现将此患者的护理体会介绍如下。 【关键词】血栓闭塞性脉管炎；糖尿病足；水胶体敷料 【Abstract】 Thrombus blockage angiitis (TAO) is that surgery is difficult to administer the nature disease，is that the common blood vessel disease，lesion memorial cyclicity break out，course of disease is long，agony is big，the disability rate is high，scheme so far still，there being no ideal treating，nursing，the heavy person amputation hard to avoid cripples.That the thrombus blockage angiitis patient combines the diabetic foot is to have added the degree of difficulty treating and nursing more，be improve a patient producing mass，avoid the patient amputation crippling，bring down patient medical treatment cost，skin nurses，the whole body nutrition supports my yard in reinforcing a wound in May，2006 for a general，left ilium of left ilium inside and outside arterial completeness blockage angiitis partner diabetic foot that surgery cures in ones refusal to do patient has been put into effect，the scheme curing the basis disease case nursing，nursing actively wins out，the patient wound is recovered within 12 cycles leaving hospital，avoid an amputation crippling.My yard follows the follow-up having carried out fixing a date lasting for 2 years on the person.This patient’s nursing understanding is introduced now as follows. 【Key words】 TAO;Diabetic foot;Hydrocolloid dressings 1 病例介绍 患者男，65岁，既往有高血压及2型糖尿病史20多年，一直坚持口服药物治疗，2002年因“不稳定型心绞痛”行冠脉搭桥术，术后仍反复出现胸闷气促，诊断为“急性左心衰”经多次住院治疗后好转出院。住院期间行双下肢血管彩色B超检查示：双下肢股浅动脉闭塞，双足背动脉内经变窄，内壁增厚(以左侧为甚)呈静脉样血流频谱；左下肢动脉频谱消失，呈静脉样血流频?。诊断为左下肢动不完全性闭塞，经抗凝、扩张周围血管,改善循环对症治疗好转出院。2006年5月23日患者诉左下肢疼痛4个月伴左足趾部溃疡2个月再次入院,检查双下肢皮肤色素沉着,温度下降，冰冷，左侧股动脉、?动脉搏动消失，双侧足背动脉搏动微弱，左侧足部第一趾及甲面第5趾溃疡，有黄色分泌物流出伴有臭味。髂动脉造影术诊断为左髂总，左髂内、外动脉完全性闭塞。患者左下肢动脉供血严重不足,