脾功能亢进症部分性脾动脉栓塞治疗术后并发症的原因分析及护理对策  

Causes and the Corresponding Nursing Measures to Complications of Partial Splenic Embolization for Hypersplenia

作　　者：游海燕[1] 陈勇[2] 代新学[1] 梁尚恩[1] 

机构地区：[1]四川省内江市第一人民医院普通外科,四川641000 [2]四川省成都市龙泉驿区第一人民医院五官科,610100

出　　处：《当代医学》2009年第5期27-29,共3页Contemporary Medicine

摘　　要：目的探讨部分性脾动脉栓塞治疗脾功能亢进症术后并发症的厡因及临床护理。方法本组127例脾功能亢进症患者,均经导管行部分性脾动脉栓塞术,栓塞剂采用明胶海绵颗粒:1.0×1.0×1.0mm3、2.0×2.0×2.0mm3、4.0×4.0×4.0mm3;术后准确统计并发症发生时间、发生率,认真分析并发症发生的原因,周密地制定护理对策,精心地指导、护理及康复。结果本组发生栓塞后综合征36.2%(46/127),脾脓肿形成4.7%(6/127),肺炎及胸膜炎22.8%(29/127),胰腺炎2.3%(3/127),肝功能损害9.4%(9/127),脾脏破裂0.7%(1/127),上消化道出血7.1%(9/127)。结论部分性脾动脉栓塞术是目前脾功能亢进症较有效的治疗方法,尽管术后并发症多而重,通过术前预见性的护理指导,术后有效的对症治疗和护理,是可以有效降低并发症、促进患者康复。Objective： To explore the causes and the corresponding nursing measures to complications of partial splenic embolization for hypersplenia. Methods： One hundred and twenty-seven patients with clinical confirmed hypersplenia were enrolled in our study, and underwent partial splenic embolization for the treatment using granula of spongia gelatinosa with the size of 1.0×1.0×1 .0mm, 2.0×2.0×2.0mm, and 4.0×4.0×4.0mm. Postoperative analysis was performed with emphasis on the time, incidence rate, and the causes of the complications occurring. According to the causes, the nursing measures were determined and carried out to promote the patients＇ rehabilitation. Results： The complications of partial splenic embolization were post embolization syndrome in 46 patients （36.2%）, splenic abscess in 6 （4.7%）, pulmonitis or pleuritis in 29 （22.8%）, pancreatitis in 3 （2.3%）, hepatic functional lesion in 9 （9.4%）, rupture of spleen in 1 （0.7%）, and upper gastrointestinal bleeding in 9 （7.1%）. Conclusion： Partial splenic artery embolization is the best approach in the treatment of hypersplenia. Though the postoperative complications are massive and of severity, they can be cured successfully by the means of prospectively preoperative introduction on discharge, and postoperative symptomatic treatment and nursing.

关 键 词：脾功能亢进症 脾动脉栓塞术 并发症 原因分析 护理对策 

分 类 号：R473.5[医药卫生—护理学]