围手术期深静脉血栓护理金毕ppt课件.ppt

* * * 卧床休息DVT发病1～2周内最不稳定，栓子极易脱落，应绝对卧床休息 保持大便通畅，避免肢体过多活动及腹压过高，引起血栓脱落 卧床期间，注意 换体位，保持皮肤清洁，防止褥疮发生 3.患肢护理 稍微抬高患肢，以利于静脉回流，减轻水肿，缓解疼痛 注意保护患肢，避免碰撞，以免皮肤损伤感染，加重病情 避免挤压和按摩患肢，以免栓子脱落 要密切观察患肢周径、颜色及温度的变化:患肢周径不断增加，颜色加深，说明静脉回流受阻，病情加重;患肢皮温升高说明出现感染 4.饮食护理? ? 高维生素、高蛋白、高热量、低脂饮食，且饮食宜清淡、易消化，忌食辛辣肥厚之品，降低血黏度，以有利疾病的恢复。 5.静脉输液的护理 要求技术操作要熟练、静脉穿刺成功率要高，避免损坏血管，并选用静脉留置穿刺针。 6.溶栓护理 应密切观察凝血功能的变化，注意出血倾向，发现牙龈出血、鼻衄、皮下出血、黑便及尿血等出血情况时，应及时通知医生处理， 急性期血栓较疏松，容易脱落，在溶栓治疗时，要更加警惕肺栓塞的发生 7.恢复期护理 慢性期(发病后一个月)应下床适当活动 增强肌肉收缩，加速静脉血液回流，防止新的血栓形成。活动应循序渐进，不可过度 避免久站 活动时穿医用弹力袜，有利于增强静脉血液回流，减轻症状 在休息时也应抬高患肢 结论 围手术期易发生深静脉血栓形成 发生深静脉血栓形成后要密切注意防止肺栓塞 下腔静脉滤器的置放应规范 DVT和PE的预防特别是手术后预防应该得到重视 常规抗凝可能成为大手术后DVT预防的理想选择 DVT的护理不容忽视，否则可酿成大祸 谢谢! Thanks * 1/2，ANDERSON 1/3 1/4 * As the clot grows it extends along the vein. Progression to the proximal veins is associated with a much greater risk of complications. DVT can develop into a chronic condition in which damage to the valves in the veins results in swelling of the leg, pain and venous hypertension (the post-thrombotic syndrome (PTS) Parts of the clot can also detach, travelling in the blood to block vessels in the lungs, so causing pulmonary embolism (PE). Prandoni P, et al. Haematologica 1997; 82:423–428. Slide A22 * 1/2，ANDERSON 1/3 1/4 * The number of patients affected by venous thromboembolism (VTE) has been estimated to be: - Deep venous thrombosis (DVT) – up to 145 patients per 100 000 population (age- and sex adjusted to the US 1980 white population) 1,2 - Pulmonary embolism (PE) – up to 69 patients per 100 000 population (Olmsted Country (USA), white population only) 3 Venous thrombosis is an important cause of morbidity and mortality, and is responsible for 300,000–600,000 hospitalisations in the USA alone each year. PE is potentially the most serious complication of VTE. 1. Gillum RF. Am Heart 1987. 1987;114:1262-1264 2. Anderso