急性主动脉夹层动脉瘤的术后分期护理研究

Study on nursing by stages for patients with acute aortic dissection during the postoperative period

目的探讨急性主动脉夹层动脉瘤患者术后不同时期的观察重点和护理。方法对25例进行急性主动脉夹层动脉瘤手术术后的患者进行术后分期护理。早期（术后1—2d）严密观察循环情况、出血量情况、呼吸系统及神经系统并发症的发生情况，做好镇静、降压、输血、吸痰等对症治疗的护理；中期（术后3—14d）指导患者饮食、活动、排泄等日常生活；晚期（术后14d后）做好出院指导，防止主动脉夹层复发。结果25例患者经过及时的诊断和手术治疗，以及合理的术后分期观察和护理，全部治愈出院，无死亡及严重并发症发生。结论对急性主动脉夹层动脉瘤患者进行术后分期观察和护理有助于促进患者的顺利康复，并对防止患者发生意外、再次发生主动脉夹层起到重要作用。

Objective To explore the key points of observing and nursing for patients with acute aortic dissection during the different stages postoperatively. Methods The nursing methods by stages were performed on 25 patients with acute aortic dissection. The stages included early stage （ 1 to 2 days after the operation）, intermediate stage （ 3 to 14 days after the operation） and advanced stage （ 14 days after the operation and later）. The key points of each stage were different. In the early stage, it needs to closely observe the circulation, the amount of blooding, the respiration system, the nerve system, and the occurrence of complications; and it also needs to do the syndrome-based nursing well, including calming, dropping blood pressure, blood transfusion, suction of phlegm and et al. In the intermediate stage, it needs to guide the daily life of the patients, including taking diet and drinking, activities, excretion and et al. In the advanced stage, it needs to do directions of discharging from the hospital and to prevent the recrudescence of aortic dissection. Results A total of 25 patients were improved in term of their symptoms or cured by our nursing care. The diagnosis was timely and the operation was suitable. The observation and nursing by stages after the operation were reasonable. All the patients were discharged from the hospital after being healed, no death and no occurrence of serious complications. Conclusions It is helpful to improve the restoration of patients with acute aortic dissection by observing and nursing care by stages, which will play an important role in promoting the smooth healing of the patients and preventing the accidents and the reoccurrence of aortic dissection.