超选择性肾动脉栓塞术治疗肾损伤性出血围手术期护理体会  

Experiences of Perioperative Nursing Strategy on the Ultraselective Embolization of Renal Artery in the Management of Acute Renal Traumatic Hemorrhage

作　　者：童耀英[1] 徐平[1] 王卫东[1] 王春新[1] 

机构地区：[1]南京医科大学附属无锡市人民医院DSA导管室,无锡214023

出　　处：《中国现代手术学杂志》2011年第4期303-305,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的总结超选择性肾动脉栓塞术治疗肾损伤性出血围手术期的护理体会。方法回顾性分析25例闭合性肾损伤患者在数字减影血管造影(digital subtraction angiography,DSA)下使用明胶海绵或金属弹簧圈进行超选择性肾动脉栓塞术患者护理资料。结果 25例患者经超选择肾出血动脉插管栓塞治疗后临床症状很快得到缓解,3～24 h尿液转清。2例休克患者血压1～2 h内恢复正常。2例出现穿刺侧足背动脉搏动消失、局部皮肤温度降低现象,经过适当放松减压后症状均缓解。2例在行肾动脉栓塞后患侧腰部胀痛不适,能耐受。术后18例出现不同程度体温升高,在37.5℃～38.6℃之间,持续1～3 d,经对症处理降至正常。均获随访,平均6(3～12)个月,所有患者经B超检查,双肾形态对称,无异常改变。肾功能检查无异常。结论术前健康宣教,术中积极配合,术后密切观察病情,对减少超选择性肾动脉栓塞术并发症发生并帮助病人顺利度过围手术期均具有十分重要的作用。Objective To study the perioperative nursing experiences of super-selective renal artery embolization in the management of acute renal traumatic hemorrhage. Methods Retrospective analysis was used in 25 cases of blunt renal injury treated by super-selective renal artery embolization under digital subtraction angiography （DSA）. After super-selective renal artery cathetorization, all cases were embolized by gelatin sponge or metal spring coil. Results The clinical symptoms all relieved after superselective renal arterial embolization. In 2 eases of shock, the blood pressure returned to normal in 1 to 2 hours. In all the patients, the urine turned clean in 3 to 24 hours. No severe complication occurred. Conclusion Detailed preoperative health education, active intraoperative cooperation and elaborative postoperative observation are very helpful to the prognosis of renal injury bleeding, and also can reduce the complication rate.

关 键 词：出血 肾 栓塞 治疗性 肾动脉 

分 类 号：R473.6[医药卫生—护理学]