AngioJet机械吸栓联合导管接触性溶栓治疗急性下肢深静脉血栓形成围手术期护理分析

Perioperative Nursing Care of Angiojet Mechanical Thrombus Aspiration Combined with Catheter Contact Thrombolysis in the Treatment of Acute Lower Extremity Deep Venous Thrombosis

目的分析AngioJet机械吸栓联合导管接触性溶栓治疗急性下肢深静脉血栓(DVT)形成的围手术期护理。方法选取2020年1月至2021年12月本院收治的DVT患者总共38例进行研究,均采取AngioJet机械吸栓联合导管接触溶栓治疗,同时围手术期做好有关护理工作,观察患者的手术情况以及手术前后活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)及D-二聚体(D-D)水平、生存质量测定量表(QOL-100)评分及小腿腿围情况。结果38例患者均顺利结束手术,1例患者于术中产生胸闷和心悸症状,心电监护显示心率为43次/分,暂停操作和对症处理之后心率回升,结束手术后未产生不适。38例患者术后经造影发现堵塞静脉全部再通,未出现颅内出血和肺栓塞等严重并发症,住院过程中平均尿激酶用量为177万U。术后,患者APTT及PT水平较术前延长,D-D、FIB水平较术前降低,腿围较术前减小,心理状态、生理状态、社会关系、独立能力以及生活状况方面的QOL-100评分较术前升高(均P<0.05)。结论AngioJet机械吸栓联合导管接触性溶栓治疗急性下肢DVT的同时做好围手术期护理能确保患者顺利结束手术,改善其凝血功能和生存质量,减轻其肢体肿胀程度,防止并发症发生。

Objective To analyze the perioperative nursing of Angiojet mechanical thrombus aspiration and catheter contact thrombolysis in the treatment of acute lower extremity deep venous thrombosis(DVT).Methods A total of 38 patients with DVT treated in our hospital from January 2020 to December 2021 were selected for the study.They were treated with Angiojet mechanical thrombus aspiration and catheter contact thrombolysis.At the same time,relevant nursing work was done during the perioperative period.The operation conditions,the levels of activated partial prothrombin time(APTT),prothrombin time(PT),fibrinogen(FIB)and D-Dimer(D-D)before and after operation were observed Qol-100 score and leg circumference.Results All 38 patients successfully completed the operation.One patient had chest tightness and palpitation during the operation.ECG monitoring showed that the heart rate was 43 beats/min.after the operation was suspended and symptomatic treatment,the heart rate picked up,and there was no discomfort after the operation.All the blocked veins were recanalized after angiography in 38 patients.There were no serious complications such as intracranial hemorrhage and pulmonary embolism.The average dosage of urokinase during hospitalization was 1770000 U.After operation,the levels of APTT,and PT were prolonged,the levels of D-D and FIB were decreased,the leg circumference was reduced,and the qol-100 scores of psychological state,physiological state,social relationship,independent ability and living conditions were increased(all P<0.05).Conclusion Angiojet mechanical thrombus aspiration and catheter contact thrombolysis in the treatment of acute lower limb DVT,while doing well in perioperative nursing can ensure the smooth completion of the operation,improve the coagulation function and quality of life,reduce the degree of limb swelling and prevent complications.