1例行冠状动脉造影患者拔管过程中桡动脉鞘管断裂的紧急处理

doi:10.3761/j.issn.0254-1769.2025.12.016

摘要/Abstract

摘要：

总结1例冠心病患者经桡动脉路径行冠状动脉造影后拔除桡动脉鞘管过程中发生鞘管断裂遗留在桡动脉的护理经验。护理要点：启动应急转运流程，缩短救治转运时间；协助定位鞘管位置，为手术切口选择提供依据；动态评估止血效果，预防桡动脉闭塞；密切监测疼痛与体征，预防血管迷走神经反射；全程心理干预，减轻患者及家属心理负担。该患者经血管外科紧急手术成功取出断裂鞘管，术后6 d转心外科行冠状动脉旁路移植术，23 d后康复出院。随访3个月，患者术肢血运良好，切口愈合佳。

关键词: 经皮冠状动脉造影, 桡动脉, 鞘管断裂, 护理

Abstract:

To summarize the nursing experience of a patient with coronary heart disease who was left in the radial artery during the removal of the radial artery sheath after coronary angiography via the radial artery pathway. Nursing points：to start the emergency transfer process，to shorten the treatment transfer time；to assist to locate the position of the sheath to provide a basis for the selection of surgical incision；to conduct dynamic assessment of hemostatic effect，prevention of radial artery occlusion；to closely monitor pain and signs to prevent vasovagal reflex；to implement the whole psychological intervention，and to reduce the psychological burden of patients and their families. The ruptured sheath tube was successfully removed by emergency surgery of vascular surgery. A total of 6 days after the operation，the patient was transferred to cardiac surgery for coronary artery bypass grafting，and was discharged 23 days later. After 3 months of follow-up，the blood supply of the limbs was good，and the incision healed well.

Key words: Percutaneous Coronary Angiography, Radial Artery, Sheath Tube Fracture, Nursing Care

朱雪清, 葛杨, 何朝凯, 张烨, 李萌, 王丽婷, 滕少章, 夏莹, 钱浩. 1例行冠状动脉造影患者拔管过程中桡动脉鞘管断裂的紧急处理[J]. 中华护理杂志, 2025, 60(12): 1508-1511.

ZHU Xueqing, GE Yang, HE Chaokai, ZHANG Ye, LI Meng, WANG Liting, TENG Shaozhang, XIA Ying, QIAN Hao. Emergency management of radial artery sheath dissection during extubation in a routine coronary angiography patient[J]. Chinese Journal of Nursing, 2025, 60(12): 1508-1511.

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