球囊扩张术联合溶栓治疗下肢动脉硬化闭塞症并发症的观察及护理

Nursing of complications from arterial occlusion of lower extremity treated with percutaneous balloon angioplasty and thrombolysis

目的总结下肢动脉闭塞症患者行球囊扩张术联合动脉导管内溶栓治疗并发症的观察及护理要点。方法给予18例下肢动脉闭塞症患者行球囊扩张术联合溶栓治疗,总结并发症发生情况及护理要点。结果 17例(占94.4%)患者术后下肢血运恢复好,静息痛及麻痹症状好转出院,1例(占5.6%)出现急性肾功能衰竭死亡。7例(占38.9%)患者术后出现并发症,其中2例(占11.1%)为穿刺部位瘀斑,1例(占5.6%)为应激性高血糖,1例(占5.6%)为高血压危象,1例(占5.6%)为新发腔隙性脑梗死伴肺炎,1例(占5.6%)为上消化道出血,1例(占5.6%)为急性肾功能衰竭。结论球囊扩张术联合溶栓治疗下肢动脉闭塞症并发症发生率较高。护理人员必须掌握患者并发症相关护理知识,前瞻性地评估病情,密切观察患者病情变化情况,及时采取有效的预防措施,减轻或预防并发症发生,促进患者康复。

Objective To summarize the nursing key points of complications from arterial occlusion of lower extremity treated with percutaneous balloon angioplasty and thrombolysis. Methods 18 patients with complications from arterial occlusion of lower extremity were treated with percutaneous balloon angioplasty and thrombolysis. The complications as well as the nursing interventions were summarized. Results Of the 18 patients, 17（94.4%） had blood circulations in lower extremities recovered and were discharged when rest pains and palsy were alleviated. 1 patient died from acute renal failure. 7 of them （38.9%） had postoperational complications and one of them （5.6%） contracted with stress hyperglycemia, 1 （5.6%） with hypertensive crisis, 1 （5.6%） with lacunar infarction combined with pneumonia, 2 （11.1%） with ecchymosis at punctured spots, 1（5.6%） with upper gastrointestinal bleeding and 1（5.6%） with acute renal failure. Conclusions Percutaneous balloon angioplasty has a high incidence of complications. Mastery of the complication-related nursing knowledge, prospective assessment of the complications, close observation of the complications and effective measures to prevent them may be effective for the prevention of complication so as to alleviate the patient＇s sufferings.