经尿道前列腺等离子双极电切术后并发原发性纤溶亢进患者的护理(3例)

Nursing Care of 3 Patients with Postoperative Acquired Primary Hyperfibrinolysis Secondary to Bipolar Plasmakinetic Transrethral

回顾性分析2014年1月至2016年12月3例经尿道前列腺等离子双极电切术后并发原发性纤溶亢进患者的护理资料,细致观察病情,建立有效的静脉通路,遵医嘱静脉输注纤溶抑制剂(氨基己酸、氨甲环酸、抑肽酶)和补充纤维蛋白原(新鲜冷冻血浆),停用蛇毒血凝酶类止血药,加快膀胱冲洗速度,保持导尿管引流通畅、动态监测血红蛋白、凝血功能、预防感染、营养支持及做好心理护理。3例拔除导尿管后排尿通畅,均痊愈出院。经尿道前列腺等离子双极电切术后可继发获得性原发性纤溶亢进,经过有效的早期诊断、及时治疗及精心护理,可获得良好的临床疗效。

ObjectiveTo analyze and discuss the nursing strategy for postoperative acquired primary hyperfibrinolysis secondary to bipolar plasmakinetic transrethral resection of the prostate MethodsThis paper summarizes the process of nursing care of 3 patients with postoperative acquired primary hyperfibrinolysis secondary to bipolar plasmakinetic transrethral resection of the prostate in our hospital from January 2014 to December 2016 Meticulous observation, establish an effective venous access,Intravenous infusion of fibrinolytic inhibitors （aminocaproic acid, tranexamic acid, aprotinin） and supplemental fibrinogen （fresh frozen plasma）, stop using the snake venom blood coagulation enzymes hemostatic, accelerate bladder washing speed, keep the catheter drainage unobstructed, dynamic monitoring of hemoglobin and blood coagulation function, prevention of infection, nutritional support and psychological nursing Results3 patients got normal urination after remove the catheter and were discharged from hospital after recovery ConclusionsAcquired primary hyperfibrinolysis may occur after BT-TURP, early diagnosis, timely treatment and careful nursing can achieve satisfactory results.