下肢动脉闭塞症介入术后留置动脉导管溶栓治疗护理体会.docVIP

下肢动脉闭塞症介入术后留置动脉导管溶栓治疗的护理体会 　　doi：10.3969/j.issn.1007-614x.2014.10.79 　　摘 要 目的：探讨动脉留置导管溶栓治疗的护理措施。方法：回顾132例动脉留置导管患者的治疗护理资料。结果：堵管4例，鞘管部分脱出2例，穿刺点血肿4例，穿刺点出血5例，过度灌注综合征22例，血栓栓塞1例，皮下出血5例，其他脏器出血3例。3例无好转出院，3例转骨外科截肢治疗，1例死于心力衰竭，125例好转出院。结论：护士的专业知识和技术、精心护理、慎独精神是保证动脉导管位置正确、用药精确、时间准确的前提，是保证治疗效果的重要环节。 　　关键词 下肢动脉闭塞症术后 术后留置动脉导管溶栓治疗 护理 　　Nursing experience of the arterial catheter thrombolysis therapy after lower extremity arterial occlusive disease intervention 　　Yang Jie 　　The Forestry General Hospital of Inner Mongolia（Yakeshi，Inner Mongolia），022150 　　Abstract Objective：To explore the nursing measures of artery indwelling catheter thrombolysis therapy.Methods：We retrospective analyzed the data of 132 patients with arterial catheter treatment and care information.Results：4 cases were pipe blockage， 2 cases were part of the prolapse sheath，4 cases were puncture site hematoma，5 cases were hemorrhage of puncture point，22 cases were hyperperfusion syndrome，1 cases was thromboembolism，5 cases were subcutaneous hemorrhage，3 cases were other organ hemorrhage.3 cases had no improved and discharged，3 cases were turned to bone surgical treated by amputation，1 cases died of heart failure，125 cases were improved and discharged.Conclusion：Nurses professional knowledge and technology，careful nursing，Shendu spirit is a prerequisite to ensure the correct position，use accurate arterial catheter，time accurate，it also is an important link to ensure the treatment effect. 　　Key words Arterial occlusive disease of lower extremity after operation；Postoperative indwelling arterial catheter thrombolysis therapy；Nursing 　　动脉导管溶栓是治疗合并血栓形成的下肢动脉闭塞性疾病的方法之一，具有药物作用直接、用药量少等优点[1]。留置动脉导管位置正确通畅，是溶栓药物准确、准时、准量到达病变部位的保证，对治疗效果至关重要。术后护理是预防并发症的重要环节。2010年1月-2014年1月我院介入科动脉置管持续溶栓治疗下肢缺血性疾病患者132例，总结护理工作经验如下。 　　资料与方法 　　本组患者132例，女19例，男113例；年龄53～82岁，平均65.5岁；其中左下肢27例，右下肢22例，双下肢83例；病程3小时～5年，合并高血压43例，合并糖尿病49例，并发糖尿病足4例；吸烟史94例。临床表现为患肢发凉、麻木、感觉异常、间歇性跛行等症状，进一步发展可出现静息痛及组织坏疽、缺血性神经病变、皮肤色泽改变、皮肤附属器营养障碍、失用性肌萎缩及关节僵硬等症状[2]。 　　治疗：123例择