紫杉醇药涂球囊治疗股腘动脉硬化闭塞症的护理  

Nursing of paclitaxel coated balloon in the treatment of femoral popliteal arteriosclerosis obliterans

作　　者：张艳[1] 米颖[1] 杨森[1] ZHANG Yan;MI Ying;YANG Sen(Department of Vascular Surgery,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院血管外科,天津300192

出　　处：《中国城乡企业卫生》2024年第5期192-195,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

基　　金：天津市科技计划项目(18ZXDBSY00110)。

摘　　要：目的探讨紫杉醇药物涂层球囊(DCB)治疗下肢股腘动脉粥样硬化闭塞症(ASO)的多元化临床护理。方法选取天津市第一中心医院2018年1月—2019年4月收治的28例ASO患者。患者围术期采用叙事护理给予心理疏导、指导戒烟;舒适护理缓解疼痛,加强足部护理;Orem护理模式健康宣教,建立新的自理模式;预见性护理预防并发症;快速康复护理指导患者功能训练;延续护理出院指导。观察患者踝肱指数(ABI)变化、卢瑟福分级变化。结果术后患者平均ABI为(0.91±0.147)、术后1年患者平均ABI为(0.85±0.112),均高于术前的(0.47±0.285),差异均有统计学意义(t=8.265、6.305,P<0.05);术后1年,患者平均ABI为(0.85±0.112),与患者术后平均ABI为(0.91±0.147)比较,差异无统计学意义(t=1.707,P>0.05)。患者术后及术后1年与术前比较,Rutherford分级均不同程度提高,无靶病变血管再狭窄,无治疗侧下肢截肢、死亡灾难性事件。结论DCB对股腘动脉粥样硬化治疗安全、有效,多元化护理对策预防并发症发生,促进机体康复,提高健康意识,促进健康行为建立,减少病情复发的风险,有利于提高患者的生活质量,促进这一里程碑式技术有更好的应用前景。Objective To explore the diversified clinical nursing of paclitaxel coated balloon(DCB)in the treatment of lower limb femoral popliteal atherosclerosis obliterans(ASO).Methods A total of 28 ASO patients admitted to Tianjin First Central Hospital from January 2018 to April 2019 were selected.Patients during the perioperative period were given narrative nursing to provide psychological counseling and guidance to quit smoking;comfortable nursing to relieve pain and strengthen foot nursing;Orem nursing model health education to establish a new self-care model;anticipatory nursing to prevent complications;rapid rehabilitation nursing to guide patients in functional training;continuing nursing for discharge guidance.The changes in ankle brachial index(ABI)and Rutherford grading in patients were observed.Results The average ABI of postoperative patients was(0.91±0.147),and the average ABI of patients one year after surgery was(0.85±0.112),both higher than that before surgery with(0.47±0.285),and the differences were statistically significant(t=8.265,6.305,P<0.05);one year after surgery,the average ABI of the patient was(0.85±0.112),and there was no statistically significant difference compared to(0.91±0.147)of the average ABI of the patient after surgery(t=1.707,P>0.05).After surgery and 1 year after surgery,compared with preoperative,the Rutherford grade of the patient improved to varying degrees,without target lesion vascular restenosis,without treatment side lower limb amputation or catastrophic events of death.Conclusion DCB was safe and effective in the treatment of femoral and popliteal atherosclerosis.Diversified nursing strategies could prevent complications,promote body recovery,improve health awareness,promote the establishment of healthy behaviors,reduce the risk of disease recurrence,which was conducive to improving the quality of life of patients,and promote this milestone technology to have a better application prospect.

关 键 词：下肢动脉硬化闭塞症 股腘段病变 药物涂层球囊 多元化护理 

分 类 号：R473.6[医药卫生—护理学]