双胎妊娠合并StanfordA型主动脉夹层患者行剖宫产及孙氏手术的围手术期护理  

Perioperative care of twin pregnancy patients with Stanford type A aortic dissection undergoing cesarean section and Sun's surgery

作　　者：陈功 张桃桃 聂小菲 程利 罗湘玉 郭菁菁 文铭浚 CHEN Gong;ZHANG Taotao;NIE Xiaofei;CHENG Li;LUO Xiangyu;GUO Jingjing;WEN Mingjun

机构地区：[1]湖北医药学院护理学院,十堰市442000

出　　处：《中华急危重症护理杂志》2024年第4期338-340,共3页Chinese Journal of Emergency and Critical Care Nursing

基　　金：湖北医药学院护理学院2023年度研究生科技创新项目(yjc2023002)。

摘　　要：总结1例双胎妊娠合并StanfordA型主动脉夹层患者行剖宫产及孙氏手术的围手术期护理体会。针对患者夹层撕裂范围广、双胎且处于孕晚期、护理难度大的特点,术前合理搬运、控制好心率及血压、保护胎儿,平稳过渡至手术;术中预防压力性损伤,加强体温管理;术后对循环及容量精细化管控、连续性肾脏替代治疗清除体内水分和毒素、预防并发症,同时加强营养支持、落实产科护理、实施个性化心理支持。经过43d精心治疗和护理,患者顺利出院,母婴结局良好。To Summarize the perioperative nursing experience of a twin pregnancy patient with Stanford type A aortic dissection undergoing cesarean section and Sun's surgery.In response to the wide range of dissection tears in the patient,twins in late pregnancy,and high difficulty in nursing,we implemented reasonable preoperative handling,control of heart rate and blood pressure,protection of the fetus to ensure the smooth transition to surgery.We also prevented pressure injuries during surgery and strengthened temperature management,and provided postoperative fine control of circulation and volume,continuous renal replacement therapy to remove water and toxins from the body,prevention of complications,while strengthening nutritional support,implementing obstetric care and personalized psychological support.After 43 days of careful treatment and care,the patient was discharged smoothly and the maternal and infant outcomes were good.

关 键 词：妊娠 双胎 动脉瘤 夹层 剖宫产术 围手术期护理 

分 类 号：R473.71[医药卫生—护理学]