中国保健营养（中旬刊）
中國保健營養（中旬刊）
중국보건영양（중순간）
China Hwalth Care & nutrition
2013年
11期
35-35,36
,共2页
肠系膜上动脉%栓塞%护理
腸繫膜上動脈%栓塞%護理
장계막상동맥%전새%호리
Superior Mesenteric Artery%Embolism%Nursing
目的：探讨急性肠系膜上动脉栓塞取栓术后重症监护室护理方法。方法：回顾性分析重症监护室1999～2008年收治17例肠系膜上动脉栓塞病例。17例按照腹膜刺激征阳性和阴性分为A组和B组。术前A组和B组分别经CTA三维重建和动脉造影确诊。全麻后行剖腹探查、肠系膜上动脉切开取栓、肠切肠吻合术。术后转入外科监护室，予抗凝、全胃肠外营养，肾功能不全及脓毒血症者接受血液滤过治疗，并行精心护理。要求护士充分掌握抗凝剂治疗剂量和方法、人工呼吸机使用和升压药的正确配制及并发症的观察和护理要点。结果：术后死亡10例，死亡率58.8%，A组死亡8例，B组死亡2例。A组死亡率、术后监护室住院时间、升压药物应用时间、机械通气时间均高于B组(p＜0.05).结论：早诊断、及时恰当的手术方式、ICU专科技能的良好应用、准确细致的观察及护理是影响肠系膜上动脉栓塞取栓术后预后的有效措施。
目的：探討急性腸繫膜上動脈栓塞取栓術後重癥鑑護室護理方法。方法：迴顧性分析重癥鑑護室1999～2008年收治17例腸繫膜上動脈栓塞病例。17例按照腹膜刺激徵暘性和陰性分為A組和B組。術前A組和B組分彆經CTA三維重建和動脈造影確診。全痳後行剖腹探查、腸繫膜上動脈切開取栓、腸切腸吻閤術。術後轉入外科鑑護室，予抗凝、全胃腸外營養，腎功能不全及膿毒血癥者接受血液濾過治療，併行精心護理。要求護士充分掌握抗凝劑治療劑量和方法、人工呼吸機使用和升壓藥的正確配製及併髮癥的觀察和護理要點。結果：術後死亡10例，死亡率58.8%，A組死亡8例，B組死亡2例。A組死亡率、術後鑑護室住院時間、升壓藥物應用時間、機械通氣時間均高于B組(p＜0.05).結論：早診斷、及時恰噹的手術方式、ICU專科技能的良好應用、準確細緻的觀察及護理是影響腸繫膜上動脈栓塞取栓術後預後的有效措施。
목적：탐토급성장계막상동맥전새취전술후중증감호실호리방법。방법：회고성분석중증감호실1999～2008년수치17례장계막상동맥전새병례。17례안조복막자격정양성화음성분위A조화B조。술전A조화B조분별경CTA삼유중건화동맥조영학진。전마후행부복탐사、장계막상동맥절개취전、장절장문합술。술후전입외과감호실，여항응、전위장외영양，신공능불전급농독혈증자접수혈액려과치료，병행정심호리。요구호사충분장악항응제치료제량화방법、인공호흡궤사용화승압약적정학배제급병발증적관찰화호리요점。결과：술후사망10례，사망솔58.8%，A조사망8례，B조사망2례。A조사망솔、술후감호실주원시간、승압약물응용시간、궤계통기시간균고우B조(p＜0.05).결론：조진단、급시흡당적수술방식、ICU전과기능적량호응용、준학세치적관찰급호리시영향장계막상동맥전새취전술후예후적유효조시。
Objective:To discuss the postoperative nursing experience in ICU on superior mesenteric arterial(SMA) embolism.Methods:The clinical materials of 17 cases of SMA emoblism were analyzed retrospectively. Al cases were divided into group A and group B respectively depending on the positive and negative result of peritoneal irritation sign. The diagnosis of group A and group B were confirmed by CTA and 3D reconstruction and arteriography respectively. The laparotomy and exploration, embolectomy of SMA and enterectomy were undergone under general anesthesia. Al cases were transferred to surgical intensive care unit and given anticoagulation and parenteral nutrition. The patients with renal dysfunction and sepsis underwent hemofiltration therapy. Results:Ten cases died, mortality 58.8%. Eight cases died in group A, and 2 cases died in group B. The mortality, ICU hospitalization, duration of pressor agents administration and-mechanical ventilation in group A exceeded those in group B (p<0.05). CTA and 3D reconstruction(average 27.0±2.6min) took less time than arteriography(average 60.0±10.8min) on diagnosis (p<0.001).Conclusion:early diagnosis and therapy、reasonable operative choose and accurate postoperative observation were closely related to prognosis of Superior mesenteric arterial(SMA) embolism by thrombectomy.
