中华护理杂志 ›› 2019, Vol. 54 ›› Issue (5): 682-685.DOI: 10.3761/j.issn.0254-1769.2019.05.009

• 专科实践与研究 • 上一篇    下一篇

颈内动脉闭塞复合再通手术的护理配合

汤红艳,王征,张虹,李巍,孙萌萌,焦力群()   

  1. 100053 北京市首都医科大学宣武医院介入放射科
  • 收稿日期:2018-12-04 出版日期:2019-05-15 发布日期:2019-05-05
  • 通讯作者:
  • 作者简介:汤红艳:女,大专,主管护师,E-mail: 13651399726@139.com
  • 基金资助:
    基金项目院国家重点研发计划项目(2016YFC1301700)

Nursing cooperation for hybrid recanalization surgery of internal carotid artery occlusion

TANG Hongyan,WANG Zheng,ZHANG Hong,LI Wei,SUN Mengmeng,JIAO Liqun()   

  • Received:2018-12-04 Online:2019-05-15 Published:2019-05-05

摘要:

总结传统颈内动脉内膜剥脱手术与复合再通手术护理配合要点:①根据术前脑血管造影结果,提前准备用物,并熟悉其性能和使用方法;②手术室仪器布局合理,避免术中反复移动;③患者体位及无菌区域的护理;④管路的固定及护理;⑤导管和血管鞘在血栓预防中的使用及术中抗凝配合;⑥术中观察使用肝素钠的剂量并配合追加给药;⑦术中并发症的观察及护理。本组69例再通成功,1例行数字减影血管造影后即显示再通,1例出现颈内动脉海绵窦瘘,立即停止手术,未造成不良后果,所有切口均为一级愈合。

关键词: 动脉闭塞性疾病, 颈动脉, 放射摄影术, 介入性, 手术中护理, 手术室

Abstract:

From nursing cooperation experiences for the hybrid recanalization surgery of internal carotid artery occlusion,key points of nursing cooperation were summarized for the traditional carotid endarterectomy and hybrid interventional surgery:①According to the results of preoperative cerebral angiography,surgery supplies were prepared in advance. ②Equipment in the operating room should be organized rationally to avoid repeated movement of the instrument. ③Patient positioning and care of aseptic area. ④Catheter fixation and care. ⑤Usage of catheters and vascular sheaths for thrombosis prevention and intraoperative cooperation for using anticoagulant.⑥Dose observation for usage of heparin sodium during surgery and additional administration of medicine. ⑦Observation of intraoperative complications and nursing measures. 69 cases were recanalized successful,one case showed recanalization immediately subtraction angiography, one case showed internal carotid cavernous sinus fistula,and the surgery was stopped immediately without causing adverse consequences. All wounds were healed in the first degree.

Key words: Arterial Occlusive Diseases, Carotid Arteries, Radiography, Interventional, Intraoperative Care, Operating Rooms