肾上腺静脉取血分型定位原发性醛固酮增多症的护理措施

Nursing of Patients after Adrenal Venous Sampling for Classification and Localization of Primary Aldosteronism

目的探讨经导管行肾上腺静脉取血(adrenal venous sampling,AVS)分型定位原发性醛固酮增多症(primary aldosteronism,PA)的护理要点。方法利用股静脉导管插管对46例PA患者行AVS检查,测定肾上腺分泌功能。结果(1)46例PA患者中43例双侧AVS成功,成功率为93%;22例提示为醛固酮瘤,21例提示为双侧肾上腺增生。(2)检查过程中,45例患者能配合AVS检查;1例因过分紧张、血压升高而取消检查,38例患者主诉紧张,30%的患者术后自觉双侧或单侧腰痛。结论做好心理护理及术中配合,加强术后并发症的观察和预防,是确保AVS成功率和准确性的关键。

Abstract：Objective To discuss the nursing strategies of adrenal venous sampling （AVS） through a catheter for classification and localization of primary aldosteronism （PA）. Methods Adrenal excre- tion function was determined in 46 patients with PA by AVS through femoral vein intubation. Re- sults In the 46 PA patients, successful bilateral AVS was achieved in 43 patients （93%）, the re- suits indicated aldosterone-produeing adenoma （APA） in 22 patients and bilateral adrenal hyper- plasia in 21 patients. During the examination, 45 patients could cooperate with the operation, but the operation was aborted in 1 case due to excessive nervousness and blood pressure elevation. Thirty-eight patients reported nervousness during the examination, and 30% of the patients complained of bilateral or unilateral lumbar pain. Conclusion Psychological nursing of the patients and the patients＇ cooperation during the operation as well as observation and prevention of the postoperative complications are keys to the success and accuracy of AVS.