阿替普酶在血栓继发下腔静脉阻塞患者中的应用效果及护理

目的探讨阿替普酶在血栓继发下腔静脉阻塞患者中的应用效果及护理体会。方法对25例血栓继发下腔静脉阻塞的患者经溶栓导管泵入阿替普酶,观察其治疗效果及总结护理要点。结果 25例患者经导管溶栓后下腔静脉通畅率>50.0%;溶栓过程中发生颅内出血1例,穿刺点出血1例,牙龈出血2例,经对症治疗后好转出院,随访3-6个月,无1例出现下肢深静脉血栓(deep vein thrombosis,DVT)及肺栓塞。结论阿替普酶对下腔静脉阻塞有良好的治疗效果,但溶栓过程可能造成出血,应严密监测凝血指标,做好针对性的护理,其是保证溶栓效果、降低出血发生率的关键。

Objective To explore the application of alteplase in patients with vena cava obstruction secondary to thrombosis and to summarize the nursing processes.Methods The effects of alteplase which was pumped through thrombolysis catheter in twenty-five patients diagnosed with vena cava obstruction secondary to thrombus were investigated and the nursing processes were summarized.Results Among those twenty-five patients treated with catheter-directed thrombolysis,over 50% of them obtained blood reflow.During the thrombolysis procedure,intracerebral hemorrhage happened in one patient,bleeding at the puncture sites in one patient and gums bleeding in two patients.They were all discharged from hospital after symptomatic treatment.No relapse of DVT or pulmonary embolism was observed during the follow up period of 3-6 months.Conclusions Although the treatment effect of alteplase is satisfactory,it may cause bleeding at various sites.This warrants an intensive coagulation monitoring during thrombolysis procedure and targeted nursing steps.These are the prerequisites of improved thrombolysis effects and minimized bleeding complications.