介入栓塞治疗脾亢的不良反应和护理

目的总结海藻酸钠栓塞微球(KMG)行部分性脾栓塞术(PSE)治疗肝硬化脾功能亢进(脾亢)的不良反应和护理体会。方法通过对32例肝硬化并脾亢患者行PSE治疗期间的不良反应及程度,认真做好术前准备、术后护理及病情观察,重视心理护理,总结经验。结果本组32例患者发生不同程度的不良反应,包括疼痛和发热,其中有8例疼痛较为剧烈,23例出现发热,体温在37.5℃～39.5℃之间,持续时间一般为3～10d,有1例持续了1个月。4例患者出现呃逆;5例患者出现少量左侧胸腔积液;2例患者出现肝性脑病,经治疗后症状消失。1例患者于术后第一天出现上消化道大出血,经抢救无效死亡。结论 PSE术能纠正脾功能亢进,提高血WBC和PLT的数量,是一种安全、有效的治疗方法。通过严密观察患者的不良反应,提供适当的护理,可提高治疗效果和病人的生活质量。

Objective To summarize adverse reactions and nursing experience of using sodium alginate embolization microspheres （KMG） with partial splenic embolization （PSE） to treat liver cirrhosis and hypersplenism （splenomegaly）. Methods Observe adverse reactions and extents of 32 cases with cirrhosis and hypersplenism treated with PSE, prepare well for preoperative preparation, postoperative care and condition observation, pay attention to psychological care, and sum up experience. Results 32 patients in this group had adverse reactions to varying extents, including pain and fever. 8 cases had more severe pain, 23 cases had fever, the body temperatures were between 37.5℃ - 39.5℃, the duration was generally 3 - 10 days, 1 case was in fever for a month. 4 cases had hiccups; 5 cases had small amount of left pleural effusion; 2 cases had hepatic encephalopathy, symptoms of which disappeared after treatment. 1 case had upper gastrointestinal bleeding in the first postoperative day, finally died after rescue. Conclusion PSE surgery can correct hypersplenism, increase the number of WBC and PLT, is a safe and effective treatment. Through close observation of patients with adverse reactions and providing proper care, this treatment can improve the therapeutic efficacy and patients＇ quality of life.