一例全膝关节置换术后极易误诊为冠心病的肺栓塞患者护理

Nursing care of one pulmonary embolism patient after total knee arthroplasty easily misdiagnosed coronary heart disease

目的总结1例全膝关节置换术后极易误诊为冠心病的肺栓塞患者原因分析及护理体会。方法针对患者术前充分评估静脉血栓栓塞症（VTE）风险并制订VTE预防方案，术后积极抗凝和物理预防，护士密切观察患者临床症状及体征变化，关注患者主诉和实验室检查结果变化趋势，严格执行肺栓塞诊断流程，尽早明确诊断肺栓塞给予规范化治疗。结果通过治疗和护理，患者顺利出院。结论建立VTE风险评估体系并积极VTE预防，护士通过临床观察识别肺栓塞高危患者，及早诊断肺栓塞并积极治疗，同时实施有效护理措施将有助于肺栓塞患者预后。

Objective To summarize the reason and nursing experience of one pulmonary embolism patient after total knee arthroplasty easily misdiagnosed coronary heart disease. Methods For the patient to implement risk assessment of venous thromhoembolism arid develop prevention plan in preoperation, then carry out anticoagulation prevention and physical prophylaxis after operation. Nurse observe the patient changes of clinical symptom and signs, focus on the complain of patient and the changes of laboratory examination results, implement the diagnosis process of pulmonary thromboembolism. Pulmonary thromboembolism patient was definitely diagnosed and got standardized treatment. Results Through the treatment and nursing, the patient finely discharged from hospital. Conclusions To develop the system of VTE risk assessment and implement prevention measures. Nurses need to distinguish the high risk pulmonary thromboembolism patient according to the clinical observation, it is better for the pulmonary thromboembolism patient to be early diagnosed and treated, meanwhile, to implement the effective nursing measures will contribute to the prognosis of pulmonary thromboembolism patient.