经皮射频消融治疗甲旁亢在腹透患者的应用及护理干预  

Application and Nursing Intervention of Percutaneous Radiofrequency Ablation for Hyperparathyroidism in Patients using Peritoneal Dialysis

作　　者：曹芳[1] 林钦玉[1] CAO Fang;LIN Qin-yu(Department of Nephrology,Fujian Provincial Hospital,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建省立医院肾内科,福建福州350001

出　　处：《中外医疗》2020年第4期148-151,共4页China & Foreign Medical Treatment

基　　金：福建省临床重点专科建设项目资助(2017739)。

摘　　要：目的总结腹膜透析患者在接受超声引导下经皮射频消融术治疗甲状腺功能亢进的护理体会。方法方便选取2017年7月-2019年4月该院收治的63例在超声多普勒引导下经皮射频消融术治疗甲旁亢的腹膜透析患者作为研究对象,对所有患者进行护理干预,总结经皮穿刺射频消融后的护理措施。结果所有选取的患者均成功完成经皮穿刺射频消融,并且穿刺后未见明显不良反应和并发症。术后血清PTH浓度(640.57±535.14)ng/L比术前(1637.65±906.76)ng/L有明显下降,差异有统计学意义(t=8.000,P<0.001),患者治疗后的焦虑评分(47.36±4.13)分,较治疗前(54.35±4.32)分有减少,差异有统计学意义(t=17.300,P<0.001),术后血清Ca(2.25±0.25)mmol/L优于术前(2.51±0.38)mmol/L,差异有统计学意义(t=3.740,P<0.001),术后血清P(1.70±0.38)mmol/L优于术前(2.30±0.5)mmol/L,差异有统计学意义(t=8.250,P<0.001)。术后5例患者声音嘶哑,4例于1周内自行恢复,1例患者1个月内恢复,穿刺部位无出现渗血。结论腹膜透析伴甲状旁腺功能亢进患者经内科治疗无效后选择在超声引导下经皮射频消融术治疗的患者,进行合理、充分的穿刺术后护理,对射频消融术的顺利进行、减少并发症的发生极其重要。Objective To summarize the nursing experience of peritoneal dialysis patients undergoing ultrasound-guided percutaneous radiofrequency ablation for hyperthyroidism.Methods From July 2017 to April 2019,63 cases of peritoneal dialysis patients with hyperthyroidism treated by ultrasound Doppler guided percutaneous radiofrequency ablation were selected as the research objects.Nursing intervention was given to all patients,and nursing measures after percutaneous radiofrequency ablation were summarized.Results All selected patients successfully completed percutaneous radiofrequency ablation,and no obvious adverse reactions and complications were seen after the puncture.The postoperative serum PTH concentration(640.57±535.14)ng/L was significantly lower than that before operation(1637.65±906.76)ng/L,and the difference was statistically significant(t=8.000,P<0.001).The patient’s anxiety score after treatment(47.36±4.13)points,compared with before treatment(54.35±4.32)points,the difference was statistically significant(t=17.300,P<0.001).Postoperative serum Ca(2.25±0.25)mmol/L was better than before surgery(2.51±0.38)mmol/L,the difference was statistically significant(t=3.740,P<0.001),postoperative serum P(1.70±0.38)mmol/L was better than preoperative(2.30±0.5)mmol/L,the difference was Statistical significance(t=8.250,P<0.001).Five patients had hoarseness,4 patients recovered spontaneously within one week,and 1 patient recovered within 1 month without bleeding at the puncture site.Conclusion It is very important for peritoneal dialysis patients with hyperparathyroidism to choose reasonable and adequate nursing after percutaneous radiofrequency ablation under the guidance of ultrasound after medical treatment is ineffective.It is very important for radiofrequency ablation to proceed smoothly and reduce complications.

关 键 词：腹膜透析 射频消融 甲旁亢 护理 

分 类 号：R47[医药卫生—护理学]