吲哚氰绿试验联合血栓弹力图在肝脏手术患者围术期护理中的应用  

Indocyanine Green Test and Thrombelastogram in Perioperative Nursing Care of Cirrhosis Patients

作　　者：文静[1] 李代京[1] 陈宁[1] 赵艳茹[1] 秦颖[1] 李春梅[2] 吴玉容[2] 

机构地区：[1]首都医科大学附属北京地坛医院肝胆外科,北京100015 [2]首都医科大学附属北京地坛医院护理部

出　　处：《解放军护理杂志》2011年第5期67-70,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的以吲哚氰绿试验联合血栓弹力图指导肝脏手术患者围术期护理,以提高专科护理工作的科学性。方法根据吲哚氰绿15 min潴留率检测值将2004年6月至2008年6月接受手术治疗的317例肝脏手术患者分为肝储备功能良好、轻中度受损和重度受损三组,分别进行有针对性的护理工作;通过血栓弹力图检测的凝血指数评估患者的综合凝血状态,指导有创性护理操作的进行,以降低出血和软组织瘀斑、血肿等并发症的发生;通过对围术期吲哚氰绿15 min潴留率和凝血指数进行动态观察,分阶段加强术后护理。结果 317例患者入院时肝脏储备功能总体处于轻中度受损状态,术后均恢复顺利,未出现护理差错和护理并发症。结论以吲哚氰绿试验联合血栓弹力图指导肝脏手术患者围术期护理,可提高专科护理效率和护理质量,值得在今后工作中进一步推广和完善。Objective To improve the scientificity of specific nursing service using indocyanine green test and thrombelastogram for directing perioperative nursing in cirrhosis patients.Methods From June 2004 to June 2008,317 cirrhosis patients were divided into normal hepatic reserve function group,mild and moderate impaired hepatic reserve function group and severe impaired hepatic reserve function group according to the detection value of the retention rate of 15 min indocyanine green.Targeted nursing service were applied in all the patients.Coagulation index in patients with cirrhosis were used to comprehend the coagulation status,guide nursing of invasive operation so as to reduce bleeding and soft tissue ecchymosis,hematoma and other complications.Perioperative nursing were enhanced by stages guided by the retention rate and coagulation index of perioperative 15 min indocyanine green.Results 317 patients with mild and moderate impaired hepatic reserve function did not develop any nursing complications and erros and all smoothly recovered from operation.Conclusion Indocyanine green test and thrombelastogram can guide the perioperatve nursing of cirrhosis patients,improve the efficiency and quality of special nursing and thus deserve further perfection and popularization.

关 键 词：肝储备功能 凝血功能 肝硬化 围术期 护理 

分 类 号：R473.6[医药卫生—护理学]