1例妊娠晚期合并A型主动脉夹层患者的围手术期护理

doi:10.3761/j.issn.0254-1769.2025.01.005

摘要/Abstract

摘要：

总结1例妊娠晚期合并A型主动脉夹层患者的围手术期护理经验，护理要点如下。①术前基于数智化平台，提升术前准备效率；组建主动脉夹层团队，合理安排手术。②术中进行目标血压管理，避免夹层动脉瘤破裂；快速建立体外循坏，提高手术配合质量；全流程、分阶段的目标体温管理；密切监测患者病情，预防羊水栓塞；实时出血监测，加强血制品管理。③术后采用“红绿灯”康复自动评估决策系统，进行早期康复训练；多学科联合健康教育，提升自我效能。经过多学科协作及精准护理，患者手术顺利完成并于18 d后出院。每个月门诊复查，患者恢复良好。

关键词: 妊娠, 主动脉夹层, 围手术期护理, 产科护理

Abstract:

To summarize the perioperative nursing of a patient with type A aortic dissection in late pregnancy. Key points of nursing include：①timely activation of the aortic dissection emergency plan based on the intelligent platform to improve the efficiency of surgical preparation； forming an aortic coarctation team and rationalising surgical scheduling；②targeted blood pressure management to avoid the rupture of dissecting aneurysm；rapid establishment of extracorporeal circulation to improve the quality of surgical coordination；target temperature management throughout the whole process；close monitoring of the patient’s condition to prevent amniotic fluid embolism；real-time haemorrhage monitoring and enhanced blood product management；③adoption of the traffic light rehabilitation automatic assessment and decision-making system for early rehabilitation training after surgery；multidisciplinary joint health education to enhance self-efficacy. Through multidisciplinary integration and precise nursing care，the patient’s surgery was successfully completed and discharged 18 days later. With monthly outpatient review，the patient recovered well.

Key words: Pregnancy, Acute Aortic Dissection, Perioperative Nursing, Obstetrical Nursing

王梦甜, 谭奇凯, 樊峻辉, 何宇轩, 洪敏. 1例妊娠晚期合并A型主动脉夹层患者的围手术期护理[J]. 中华护理杂志, 2025, 60(1): 37-42.

WANG Mengtian, TAN Qikai, FAN Junhui, HE Yuxuan, HONG Min. Perioperative nursing care of a patient in late pregnancy complicated with acute aortic dissection：a case report[J]. Chinese Journal of Nursing, 2025, 60(1): 37-42.

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