中心静脉闭塞综合征血管腔内治疗的围手术期护理

Perioperative nursing for patients with central venous occlusion disease receiving endovascular treatment

目的探讨介入治疗中心静脉闭塞综合征的围手术期临床护理方法。方法 40例采用介入腔内治疗的中心静脉闭塞综合征的血液透析患者通过评估-干预-效果评价的护理程序思维实施整体护理。其中包括:术前做好心理护理、护理访视,术中做好护理配合和并发症观察和预防,术后做好患肢护理、病情观察、抗凝治疗护理及出院指导。结果术前患者情绪稳定,患者及家属接受及配合手术诊断治疗,通过术中、术后护理,急性心力衰竭、高血压危象、心包积液等危重并发症得到及时发现和有效处理。所有患者均康复出院。半年随访率为100%,症状复发患者得到及时发现和干预,保证了治疗整体疗效的提高。结论规范、全面、系统的整体护理是保证中心静脉闭塞综合征介入治疗的重要组成要素。

Objective To investigate the perioperative nursing strategy for patients with central venous occlusion disease who are receiving endovascular treatment. Methods According to the nursing procedure thinking of ＂evaluation-intervention-effect evaluation＂ principle, holistic nursing care was implemented in forty hemodialysis patients with central venous occlusion syndrome who were receiving endovascular treatment. The nursing measures included careful preoperative psychological nursing care and nursing visit, proper intraoperative nursing cooperation and observation of complications, and strict postoperative care of affected limb, observation of clinical condition, nursing for anticoagulation treatment and education of discharge guidance. Results Before the operation, all the patients were emotionally stable. Patients and their family members accepted the diagnosis and treatment plan, and showed willingness to cooperate with the therapy. Through the implement of intrtaoperative and postoperative comprehensive nursing measures, severe complications such as acute heart failure, hypertension crisis, pericardial effusion, etc. were promptly detected and effectively managed. All patients were recovered at the time of discharge. Half- year follow-up rate was 100%. The patients who showed recurrence of clinical symptoms were discovered and treated without delay, which ensured that the overall therapeutic efficacy could be improved. Conclusion Normative, comprehensive and systematic holistic nursing care is an important key point in order to ensure a successful interventional treatment for patients with central venous occlusion syndrome.