AngioJet血栓清除术治疗急性下肢深静脉血栓形成的术中护理实践  

The nursing cooperation in percutaneous mechanical thrombectomy for acute lower extremity deep venous thrombosis

作　　者：孙玲芳[1] 段鹏飞[1] 倪才方[1] SUN Lingfang;DUAN Pengfei;NI Caifang(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏215006

出　　处：《介入放射学杂志》2020年第12期1268-1270,共3页Journal of Interventional Radiology

摘　　要：目的总结AngioJet血栓清除术治疗急性下肢深静脉血栓形成(LEDVT)的术中护理配合经验。方法收集206例AngioJet血栓清除术治疗急性LEDVT患者的临床资料,患者均予以充分的术前准备和规范的术中护理配合,包括心理护理与术前访谈、手术器材及药品准备、手术配合、生命体征的观察、疼痛和体位变动护理、特殊用药护理、并发症预防术后处置及交接。结果 206例患者均顺利完成手术,即刻血栓清除评价:Ⅰ级9例,Ⅱ级82例,Ⅲ级115例。48例患者术中感觉不适主要为患肢胀痛、胸闷、心悸。12例高血压、5例低血压、6例窦性心动过速、145例血红蛋白尿患者,经及时护理干预后均缓解。所有患者在围手术期中均未出现急性肾功能损伤、无失血过多、症状性肺栓塞等严重并发症。结论完善的术前准备与高效而细致的术中配合是AngioJet血栓清除术安全、顺利完成的重要保障。Objective To summarize the experience in intraoperative nursing cooperation in percutaneous mechanical thrombectomy(PMT) by using AngioJet ultra thrombectomy system for the treatment of acute lower extremity deep venous thrombosis(LEDVT). Methods The clinical data of 206 patients with acute LEDVT, who were treated with AngioJet PMT, were collected. The adequate preoperative preparation and standardized intraoperative nursing cooperation were strictly implemented, which included psychological care and preoperative interview, surgical equipment and medicine preparation, surgical cooperation,observation of vital signs, nursing of pain and body position change, special medication care, complication prevention, postoperative treatment and handover of nursing matters. Results Successful AngioJet PMT was accomplished in all the 206 patients. The postoperative immediate thrombus removal evaluation showed that grade Ⅰ was achieved in 9 patients, grade Ⅱ in 82 patients and grade Ⅲ in 115 patients. In the 48 patients who felt unwell during the operation, the main complains were limb pain, chest tightness, and palpitations.Twelve patients developed hypertension, 5 patients developed hypotension, 6 patients developed sinus tachycardia, and 145 patients developed hemoglobinuria, all the above complications were relieved after timely nursing intervention. During perioperative period no serious complications, such as acute renal function injury, excessive loss of blood, symptomatic pulmonary embolism, etc. occurred. Conclusion Perfect preoperative preparation and efficient, meticulous intraoperative cooperation are the key points to ensure a safe and successful AngioJet PMT.

关 键 词：急性下肢深静脉血栓形成 药物-机械偶联血栓清除术 术中护理 

分 类 号：R473.5[医药卫生—护理学]