1例妊娠晚期合并A型主动脉夹层患者的围手术期护理  

Perioperative nursing care of a patient in late pregnancy complicated with acute aortic dissection:a case report

作　　者：王梦甜[1] 谭奇凯 樊峻辉 何宇轩 洪敏[1] WANG Mengtian;TAN Qikai;FAN Junhui;HE Yuxuan;HONG Min

机构地区：[1]浙江省人民医院/杭州医学院附属人民医院手术室,杭州市310014

出　　处：《中华护理杂志》2025年第1期37-42,共6页Chinese Journal of Nursing

基　　金：浙江省医药卫生科技项目(2023KY537);教育部产学合作协同育人项目(22077043295039)。

摘　　要：总结1例妊娠晚期合并A型主动脉夹层患者的围手术期护理经验,护理要点如下。①术前基于数智化平台,提升术前准备效率;组建主动脉夹层团队,合理安排手术。②术中进行目标血压管理,避免夹层动脉瘤破裂;快速建立体外循坏,提高手术配合质量;全流程、分阶段的目标体温管理;密切监测患者病情,预防羊水栓塞;实时出血监测,加强血制品管理。③术后采用“红绿灯”康复自动评估决策系统,进行早期康复训练;多学科联合健康教育,提升自我效能。经过多学科协作及精准护理,患者手术顺利完成并于18 d后出院。每个月门诊复查,患者恢复良好。To summarize the perioperative nursing of a patient with type A aortic dissection in late pregnancy.Key points of nursing include:①timely activation of the aortic dissection emergency plan based on the intelligent platform to improve the efficiency of surgical preparation;forming an aortic coarctation team and rationalising surgical scheduling;②targeted blood pressure management to avoid the rupture of dissecting aneurysm;rapid establishment of extracorporeal circulation to improve the quality of surgical coordination;target temperature management throughout the whole process;close monitoring of the patient’s condition to prevent amniotic fluid embolism;real-time haemorrhage monitoring and enhanced blood product management;③adoption of the traffic light rehabilitation automatic assessment and decision-making system for early rehabilitation training after surgery;multidisciplinary joint health education to enhance self-efficacy.Through multidisciplinary integration and precise nursing care,the patient’s surgery was successfully completed and discharged 18 days later.With monthly outpatient review,the patient recovered well.

关 键 词：妊娠 主动脉夹层 围手术期护理 产科护理 

分 类 号：R473.71[医药卫生—护理学]