医源性肾动脉损伤介入栓塞术的观察及护理

Observation and nursing care of patients with iatrogenic renal artery injury undergoing embolization

[目的]总结行介入肾动脉栓塞术前及术后的观察及护理。[方法]对14例医源性肾动脉损伤行介入栓塞治疗病人的护理,包括术前维持生命体征平稳、保持尿管通畅、宣教、心理护理等;术后密切观察病情变化、积极处理栓塞后综合征等。[结果]14例病人随访10个月～49个月,所有病人在术后2d～21d肉眼血尿均消失。其中1例在栓塞后13个月因术侧肾区钝性外伤再次出现血尿,再次介入栓塞后,继续随访14个月未见血尿复发。[结论]在经导管肾动脉节段性栓塞术(SRAE)的护理过程中,术前维持血压稳定、保持尿管通畅、术后监测生命体征、密切观察尿色的变化、积极处理栓塞后综合征是手术成功的保证。

Objective.To summarize the preoperative and postoperative observation and nursing of patients with iatrogenic renal artery injury undergoing embolization. Methods. The care was carried out for 14 patients with iatrogenic renal artery injury undergoing embolization, including preoperative maintaining stable vital signs, maintaining catheter patency, education, psychological care for them; postoperative close observation of changes in condition and active treatment of embolism syndromes. Results. All 14 patients were followed up for 10 months to 49 months,gross hematuria in all patients disappeared on the postoperative second day to 21st day. hematuria occurred again in 1 case on 13th month after the embolism due to surgery side kidney area blunt trauma,embolization intervention for them again, to continue followup for 14 months and no recurrence of hematuria. Conclusion. During the nursing process of transcatheter renal artery segmental embolization （SRAE）, preoperative maintaining stable blood pressure, keeping catheter patency; postoperative monitoring of vital signs and close observation of changes in urine color actively treatment of tmbolization syndrome is the key of success of care.