居洁勤，吴安乐，徐佩珍，施建国

(宁波市第一医院，浙江 宁波 315010)

·临床护理·

颈动脉支架置入术中并发症及护理对策

居洁勤，吴安乐，徐佩珍，施建国

(宁波市第一医院，浙江 宁波 315010)

目的：探讨颈动脉支架置入术治疗颈动脉狭窄并发症的危险因素及护理对策。方法选择宁波市第一医院2012年3月至2015年3月68例颈动脉狭窄度为70%～95%，行颈动脉支架置入术患者，分析发生术中并发症的相关因素及护理对策。结果本组68例患者手术成功率100%，术中出现血管迷走神经反射及低血压9例，高灌注综合征2例，血管痉挛2例，轻度神经功能缺损1例，经积极治疗和护理好转。结论充分认识引起并发症的危险因素，熟悉并发症的临床表现及治疗．及时实施护理干预，是提高手术成功率及降低并发症有效保障。

颈动脉狭窄；颈动脉支架置入术；并发症；护理对策

Abstract：[Objective] To investigate the potential risk factors and nursing countermeasures for complications during procedures in carotid artery stenting (CAS). [Method] 68 patients with internal carotid artery stenosis of 65% to 95% collected from March 2012 to March 2015 were treated by CAS. The nursing management throughout the procedure are discussed. All the potential risk factors and nursing countermeasures for complications during procedure were analyzed. [Result] Achievement ratio of CAS operation of all 68 patients was 100%. 9 patients suffered nervous reflex and hypotension, 2 patients suffered cerebral hyperperfusion syndrome, 2 patients suffered vasospasm, and 1 case suffered mild residual neurological deficits during the carotid procedures. All the complications were treated and with immediate medications and effective nursing countermeasures. [Conclusion] It is important for medical-intervention nurses to have the full realization to the potential risks for complications, be familiar with clinical manifestation and treatment of carotid artery stenosis, and perform nursing intervention timelywhich will benefit for promoting success rate of operation and relieving complications.

Keywords: carotid artery stenosis; carotid artery stenting; complications; nursing countermeasures

颈动脉狭窄大多由于颈动脉的粥样斑块导致颈动脉管腔狭窄，是脑梗死的常见病因和独立危险因素，缺血性卒中约30%由颈动脉狭窄造成[1]。随着神经介入治疗的发展，颈动脉支架置入术具有安全、有效、微创等特点，近年来已成为颈动脉狭窄的主要治疗方法之一[2]。支架置入能解除颈动脉狭窄，使狭窄的血管得以重建，大脑得到充足的血液供应，有效防止脑缺血及梗死的发生[3]。但是在支架置入过程中易出现低血压、血管痉挛、神经功能缺损等，如发现和处理不及时，常可引起严重后果。本文就68例颈动脉支架置入术中14例并发症的危险因素进行分析，并提出相应护理对策。……