6例急性肺栓塞患者实施导管接触性溶栓治疗的护理

doi:10.3761/j.issn.0254-1769.2026.03.016

摘要/Abstract

摘要：

总结6例急性肺栓塞患者实施导管接触性溶栓治疗的护理经验。护理要点：术前风险干预与准备，为治疗奠定安全基础；急性期开展基于血流动力学稳定的个体化活动，预防血栓再发；强化抗凝-溶栓的协同护理，发挥治疗的最大效价；疗效与出血双监测，提升治疗的安全有效性；留置导鞘管的集束化护理，预防并发症的发生或加重；调整饮食结构，改善血液高凝状态；进行渐进式早期康复训练，预防再栓塞和肺栓塞后综合征；关注患者心理状态，提供全程的心理护理；开展延续性护理，提高患者居家照护质量。经过精心的治疗和护理，其中1例溶栓效果欠佳，需择期行经皮肺动脉取栓术，术后8 d出院；余5例治疗效果明显，顺利出院，并持续随访3个月，均恢复良好。

关键词: 急性肺栓塞, 肺动脉导管, 尿激酶, 溶栓, 护理

Abstract:

This article summarizes nursing experience of 6 patients with acute pulmonary embolism undergoing catheter-directed thrombolysis. Key nursing points：preoperative risk intervention and preparation to establish a safe foundation for treatment；individualized activities based on hemodynamic stability during the acute phase to prevent thrombus recurrence；intensified coordinated anticoagulation-thrombolysis care to maximize therapeutic efficacy；dual monitoring of efficacy and bleeding to enhance treatment safety and effectiveness；bundled care for retained sheath tubes to prevent complications or exacerbation；dietary adjustment to improve hypercoagulable states；progressive early rehabilitation training to prevent re-embolism and post-pulmonary embolism syndrome；attention to patients’ psychological state with comprehensive psychological care；implementation of continuous care to improve home-based patient management quality. After meticulous treatment and nursing care，a case showed suboptimal thrombolysis efficacy and required elective percutaneous pulmonary artery thrombectomy，being discharged after 8 days post-surgery；the remaining 5 cases demonstrated significant therapeutic outcomes，were discharged smoothly，and showed good recovery during 3 months of continuous follow-up.

Key words: Acute Pulmonary Embolism, Pulmonary Artery Catheter, Urokinase, Thrombolysis, Nursing Care

黎文苑, 陈晓雯, 林燕琴, 杨喜红. 6例急性肺栓塞患者实施导管接触性溶栓治疗的护理[J]. 中华护理杂志, 2026, 61(3): 406-411.

LI Wenyuan, CHEN Xiaowen, LIN Yanqin, YANG Xihong. Nursing care of 6 patients with acute pulmonary embolism undergoing catheter-directed thrombolysis treatment[J]. Chinese Journal of Nursing, 2026, 61(3): 406-411.

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