腔内修复术中一期覆盖左锁骨下动脉的术后护理

Post-operative Nursing of Patients with the Left Subclavain Artery Occluded Primarily during Endovascular Repair

目的探讨胸主动脉瘤及夹层腔内修复术中左锁骨下动脉一期覆盖后的护理要点。方法对40例因近端锚定区过短,腔内修复术中一期完全覆盖左锁骨下动脉患者的术后护理进行总结与分析。结果40例患者一期完全覆盖左锁骨下动脉后,早期窃血综合征发生率为20%(8/40),左肱动脉平均收缩压(62.6±24.2)mmHg,住院期间未出现严重脑及上肢缺血并发症。结论腔内修复术中,一期覆盖左锁骨下动脉是可行的;术后对于上肢血压的监测、上肢血运状况以及窃血综合征的观察是护理的关键。

Objective To investigate the key points in nursing care of patients with the left subclavain artery（LSA） being occluded primarily in the endovascular repair（EVR） of thoracic aornc aneurysm （TAA） and thoracic aortic dissection（TAD）. Methods Our experience on nursing of 40 TAD or TAA patients with LSA occluded primarily due to short proximal landing zone was summarized and analyzed. Results In 40 patients whose LSA were covered primarily, the left subclavian steal syndrome（LSSS） occurred in 8 （20%） patients; the average systolic pressure of LSA was （62.6±24.2） mmHg. No severe complications were found in brain and upper extremity duration of hospitalization. Conclusion Primary occlusion of LSA can be enforced safely and efficiently in TAA and TAD with short proximal landing zone in EVR. The monitoring of the blood pressure of upper limbs and the observation of the blood circulation of the upper limbs and the LSSS are the keys in nursing.