一例川崎病多发冠状动脉瘤合并血栓患儿行极低剂量tPA溶栓的护理  

Nursing Care of a Child with Kawasaki Disease with Multiple Coronary Artery Tumors Complicated with Coronary Thrombosis Undergoing Extremely Low-Dose tPA Thrombolysis

作　　者：赵仕国 楼晓芳[1] 周红琴[1] 吴小花[1] 何玮梅 夏姗姗[1] 单佳妮[1] 石玉沄 张晨美[1] ZHAO Shiguo;LOU Xiaofang;ZHOU Hongqin;WU Xiaohua;HE Weimei;XIA Shanshan;SHAN Jiani;SHI Yuyun;ZHANG Chenmei(Department of Pediatric Intensive Care Unit,National Clinical Research Center for Child Health,Children’s Hospital,Zhejiang University School of Medicine,Hangzhou 310052,Zhejiang Province,China)

机构地区：[1]国家儿童健康与疾病临床医学研究中心·浙江大学医学院附属儿童医院儿科重症监护室,浙江杭州310052

出　　处：《军事护理》2024年第3期113-116,共4页MILITARY NURSING

基　　金：国家重点研发计划(2021YFC2701801)。

摘　　要：总结1例川崎病多发冠状动脉瘤合并冠状动脉血栓行极低剂量组织型纤溶酶原激活物(tissue plasminogen activator,tPA)溶栓的护理体会。护理重点为选择tPA输注静脉方案、确定基线凝血状态及是否符合tPA输注标准、被动减少tPA输注剂量,促使局部出血减缓(或停止)、加强心脏及心外并发症观察及处理、制订个体化tPA撤离方案,保证抗凝连续性。经过16 d积极治疗和精心护理,患儿救治成功,顺利出院。To summarize the nursing experience of a case of Kawasaki disease with multiple coronary artery tumors complicated with coronary thrombosis treated with very low-dose tissue plasminogen activator(tPA)thrombolysis.Nursing care focused on selecting an intravenous regimen for tPA infusion,determining baseline coagulation status and compliance with tPA infusion criteria,passively reducing the dose of tPA infusion to induce slowing(or cessation)of local hemorrhage,enhancing observation and management of cardiac and extracardiac complications,and developing an individualized tPA weaning regimen to ensure anticoagulation continuity.After 16 days of active treatment and careful nursing,the child was successfully treated and discharged smoothly.

关 键 词：川崎病 冠状动脉血栓形成 组织型纤溶酶原激活物 阿替普酶 急症护理 

分 类 号：R473.51[医药卫生—护理学]