支架植入术治疗颈动脉狭窄的临床观察和护理剖析.doc

论文题名：支架植入术治疗颈动脉狭窄的临床观察和护理 作者简介：马雪露 女 1975年出生 护理本科 主管护师 安徽省阜阳市人民医院神经内科护士长 通信地址：安徽省阜阳市人民医院神经内科 （People’s Hospital of Fu-yang Neuro Medicil ,Anhui,China） MA Xue-lu, 邮编：236003 电话 ： 邮箱： fuyangmxl@ 支架植入术治疗颈动脉狭窄的临床观察和护理 马雪露 云宗金 安徽省阜阳市人民医院神经内科 236003 ［摘 要］ 目的: 探讨颈动脉狭窄患者行血管内支架植入术治疗的临床护理。方法: 通过对接受支架置入治疗颈动脉狭窄的 40例患者进行回顾性分析，总结出颈动脉支架植入术的护理体会。结果: 本组均成功植入支架,术中出现心率下降、血压下降4例，术后6例出现穿刺部位皮下瘀斑、血肿，3例血压下降，经治疗护理均痊愈。结论: 术前充分准备，术中密切监护，术后监护和观察对提高手术的安全性和成功率有重要意义。 ［关键词］　颈动脉狭窄;血管内支架成形术;护理 Observation and nursing of patients with carotid artery stenosis undergoing percutaneous transluminal stenting MA Xue-lu, People’s Hospital of Fu-yang Neuro Medicil ,Anhui,China 236003 ［Abstract］ Objective: To observe nursing care of the patients undergoing setenting for carotid artery stenosis.Methods: By analyzing 40 cases of carotid artery stenting patients, sum up nursing experience, reasonable care program.Results: All cases of carotid artery stent placement achieved success, technical success rate was 100% in our study, 4 of patients were found to have bradycardia and decreased blood pressure duing the operation, and 6 subcutaneous haematoma in postoperation. They were all recovered after timely care and treatment.Conclusions: Preoperative adequate preparation, perioperative intensive care and monitoring of vital signs after surgery are of significance in improving the rate of success and safety in operation. ［Key words］ carotid artery stenosis; stent angloplast; nurse 颈内动脉病变在脑梗死的发生中起重要作用两个大样本的研究显示，严重颈动脉狭窄同侧梗死的发病率达90-95%，同时颈内动脉狭窄是进展性卒中的重要因素例患者均为我科2009年11月2012年月的住院病人，会阴部、双侧腹股沟备皮，碘过敏试验，术前小时禁食水，术前半小时苯巴比妥钠0.2g肌肉注射，压迫着力点欠准确，按压时间不足及患者穿刺侧下肢未能足够时间制动。例术后出现穿刺部位血肿，[1] MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis. European Carotid Surgery Trialists Collaborative Group [J]. Lancet. 1991, 337(8752): 1235-1243. [2] Hayashi K, Kitagawa N, Takahat