腹部实质脏器外伤出血超声造影介入治疗的急救护理

Effects and emergency nursing care of abdominal parenchymal organ injuries treated by contrast-enhanced ultrasonography-guided local hemostatic injection

目的探讨在超声造影（CEUS）引导下，对腹部实质脏器损伤出血进行局部注射止血剂治疗后的护理。方法分析23例急诊腹部实质脏器外伤患者灰阶超声造影引导下止血治疗的急救护理经验。对患者治疗术后第1d，第2d，第3d，第7d的生命体征监测、常规超声检查及血液血红蛋白（Hb）数值进行动态观察。结果23例患者CEUS引导注射后即刻显示无活动性出血。治疗后30min内收缩压上升至正常（P〈0.05），心率及呼吸频率恢复至正常（P〈0.05）；治疗后第3d开始Hb测值缓慢升至正常；剔除其他合并伤因素，患者平均住院日7-10d。结论CEUS引导下对腹部实质脏器外伤出血进行局部止血剂注射治疗能有效控制腹部实质脏器外伤出血。急救整体护理是保证治疗获得成功的关键之一。

Objective To investigate the effects and key points in emergency nursing care of contrast-enhanced ultrasonography （CEUS）-guided percutaneous injection of hemostat for patients with abdominal parenchymal organ trauma. Methods Twenty-three patients with abdominal parenchymal organ trauma underwent CEUS-guided successive percutaneous injection of batroxobin and absorbable cyanaloc acrylic resin adhesive, 2 kinds of hemostat, into the lesion（s） within （11.43±3.15）h after the trauma occurred. One, 3, and 7 days after the injection the vital signs, blood pressure, heart rate, and respiration were measured. Peripheral blood samples were collected to measure the hemoglobin （Hb） level. Relevant experience in emergency nursing care was summarized. Results No active bleeding was found immediately after the CEUS-guided hemostat injection. Thirty minutes after the injection, the systolic blood pressure, heart rate, respiration rate, and Hb level were increased to the normal levels （all P〈0.05）. The average length of hospital stay was 7-10 days. Conclusion CEUS-guided hemostat injection is safe and effective to the treatment of patients with abdominal parenchymal organ injuries combined with hemorrhage. Emergency holistic nursing for trauma patients plays an important role in the successful treatment.