药物洗脱支架植入术后血栓形成原因分析及针对性护理

Analysis of Thrombosis after Drug-eluting Stent Implantation and Discussion on Targeted Nursing

目的 探讨药物洗脱支架植入术后血栓形成原因分析及针对性护理.方法 选取我院2015年9月-2017年3月心内科植入药物洗脱支架的80例冠心病患者作为研究对象.比较并分析本组患者护理前后主要凝血指标D二聚体、BPC、PT、aPTT、TT等变化及分析药物洗脱支架植入术后急性或亚急性血栓形成原因并制定针对性的护理措施.结果 本组患者护理后D二聚体较护理前下降,BPC、aPTT、PT、TT均较护理前上升(P<0.05),支架本身因素、手术者操作因素、患者病情特点及合并相关疾病、抗栓药物使用的不规范均是药物洗脱支架植入术后急性或亚急性血栓形成的诱因,通过在行PCI及药物洗脱支架植入术前、术中、术后的相应护理,可降低支架内急性或亚急性血栓的形成.结论 对行PCI及药物洗脱支架植入术患者护士应当注意支架引起的血管壁机械性损伤、术中术者球囊扩张情况、患者病情特点及合并相关疾病及规范持续性的使用双抗血小板药物,并制定针对性的护理措施,可改善患者的血液高凝状态,降低支架内急性或亚急性血栓的形成.

Objective To investigate the causes of thrombosis after drug-eluting stent implantation and targeted care.Methods From September 2015 to March 2017,80 patients with coronary heart disease(CHD)were implanted with drug-eluting stents in our hospital.To compare and analyze the main coagulation index D dimer,BPC,aPTT,PT,TT before and after nursing care and to analyze the causes of acute or subacute thrombus formation after drug-eluting stent implantation and to establish appropriate nursing measures.Results After nursing care,the D dimer level decreased significantly in this group of patients than that before nursing(P<0.05,).The level of BPC,aPTT,PT,TT,was significantly higher than that of pre-nursing(P<0.05).The factors of stent itself,surgical operation,patient’s condition and complicated phase were also found in this group.The nonstandard use of anticoagulants is the cause of acute or subacute thrombosis after drug eluting stent implantation.Prior to PCI and drug-eluting stent implantation,intraoperative,postoperative and postoperative care can reduce the formation of acute or subacute thrombosis in the stent.To analyze the causes of acute or subacute thrombosis after drug-eluting stent implantation and to develop targeted nursing measures..Conclusion Nurses should pay attention to the mechanical injury caused by stent,the operation of balloon dilatation,the condition of patients and the related diseases and the use of double anticoagulant drugs for the patients with PCI and drug-eluting stent implantation.It can reduce the formation of acute or subacute thrombus in the stent.