夹层主动脉瘤实施全弓置换术的护理配合  

Nurse Cooperation of Bentall Operation for Dissecting Aneurysm

作　　者：陈迎霞 周建玲 魏红卷 董平 刘丽芹 

机构地区：[1]煤炭总医院手术室,北京100028

出　　处：《中国医药导刊》2010年第12期2161-2162,共2页Chinese Journal of Medicinal Guide

摘　　要：目的:总结5例在深低温停循环下,行主动脉瓣成形、升主动脉和主动脉弓置换术治疗夹层主动脉瘤合并主动脉瓣关闭不全的巡回护理工作。方法:采用深低温停循环的方法,最低温度17.3℃,5例手术均采用腋动脉插管,鼻咽温度降至28℃时阻断升主动脉,切开升主动脉夹层瘤,经主动脉根部灌注含钾冷血心肌保护液。部分窦切除进行主动脉瓣成形,用覆膜自膨胀支架血管置入左半弓和降主动脉近端形成"象鼻子"。切断降主动脉起始部,做三分支血管远端与降主动脉壁和覆膜支架的吻合,吻合完毕经分支血管的灌注分支插入供血管,恢复下半身循环。依次做分支血管与左颈总动脉、左锁骨下动脉和无名动脉的吻合,最后做主动脉近段人工血管与分支人工血管之间的吻合,恢复全身循环。结果:手术均顺利完成,术中巡回护士配合达预期的目的,患者术后安返监护室。结论:手术室护士术前必须充分了解患者的病情,熟知手术步骤,做好术前准备,有利于手术的顺利进行。Objective：To Summarize five patients under deep hypothermic circulatory arrest （DHCA） for Bentall operation,aortic valve plasty to treat dissecting aneurysm combined with aortic insufficiency.Methods：Under deep hypothermic circulatory arrest（DHCA）,the lowest temperature is 17.3℃.Axillary artery intubation,when the nasopharynx temperature is 28℃,clipping the ascending aorta,open the asend aortic dissecton,to the roots of the aorta pouring in cold blood myocardium protection of the potassium.Part of the sinuses are cut out to their petals forming a blood clot from to expand the covered stent in the bow and was admitted to the end of a like the nose.Cut down to the duodenum,three branches of the vessels remote and the descending aorta and the coverd stent the mast in the branches of the blood vessels and for pouting branch to branch.In order to lower the circulation of blood vessels and left the neck of the arteries and left lock bone arteries and nowhere to make up the artery of the arterial blood for the artificial and artificial blood branch.Results：The operations were completed successfully, the circuit nurses＇ coordinate well. All patients were sent to ICU safely.Conclusion：The operation nurse must know the patient state of illness and surgical procedures to cooperates with the surgery, be beneficial to the operation.

关 键 词：夹层主动脉瘤 血管置换 护士配合 

分 类 号：R472.3[医药卫生—护理学]