覆膜支架腔内隔绝术治疗腹主动脉瘤的手术配合

2012-01-29王莹

浙江医学教育 2012年6期

关键词：支架手术护理

王莹

(宁波市第二医院，浙江宁波 315010)

·基础与临床研究·

覆膜支架腔内隔绝术治疗腹主动脉瘤的手术配合

王莹

(宁波市第二医院，浙江宁波 315010)

目的：总结覆膜支架腔内隔绝术治疗腹主动脉瘤的手术配合要点。方法术前做好患者的心理护理及预防瘤体破裂出血、导管材料的准备；术中密切观察患者的生命体征及肾功能、下肢血液循环的改变；加强全身肝素化护理；导管、支架的准确传递和管理。结果28例腹主动脉瘤患者腔内隔绝手术均获成功。带膜支架释放位置好，无内漏，术中未发生不良反应。结论良好的护理配合是腹主动脉瘤腔内隔绝术成功不可缺少的重要因素之一。

腹主动脉瘤；覆膜支架；腔内隔绝术；护理配合

Abstract: [Objective] Explore and generalize the key characteristics of the nursing support for endovascular graft exclusion therapy on abdominal aortic aneurysm. [Method] We carried out preoperative psychological nursing to patients, try to prevent the possibility of bleeding caused by tumor rapture and prepare the surgery apparatus. During the surgery, we observe carefully patients’ life sign as well as other indicators such as renal function and blood circulation of lower limbs and dispatch surgery apparatus properly and accurately. [Result] All 28 operations were successful. The craft has been put at proper position and there was no internal leak. There was no adverse reaction during the surgery. [Conclusion] Good nursing support is indispensible for the success of endovascular graft exclusion therapy on abdominal aortic aneurysm.

Keywords:abdominal aortic aneurysm; stent-graf; endovascular graft exclusion; nursing coordination

腹主动脉瘤(Abdominal Aortic Aneurysm AAA)，主要是由于动脉粥样硬化而导致的血管内膜增厚，滋养细胞受压，营养障碍，血压升高，血管壁中层长时间受到损害而产生的永久性异常的扩张或膨胀[1]。多发生于老年患者，以男性多见。腹主动脉瘤腔内隔绝术(Endovascualr Exclusion, EVE)是20世纪90年代兴起的治疗腹主动脉瘤的新技术，具有病死率低、微创的优势，已成为替代外科手术的首选治疗方法[2]。2008年6月至2011年12月，我院采用该方法对28例AAA进行治疗，效果满意。本文就手术的护理配合总结如下。