【摘要】：目的探討靜脈溶栓治療急性大面積肺栓塞患者的護(hù)理方法。方法回顧性分析2015年同濟(jì)大學(xué)附屬上海市肺科醫(yī)院心肺循環(huán)科治療的36例急性大面積肺栓塞患者的臨床資料。所有患者均給予微量注射泵靜脈注射注射用阿替普酶治療,在溶栓前、中、后均實(shí)施對癥護(hù)理及肺血管病�？谱o(hù)理,嚴(yán)密觀察患者的生命體征及穿刺處皮膚等情況,并進(jìn)行血常規(guī)、出凝血時間等實(shí)驗(yàn)室檢查,及時發(fā)現(xiàn)出血等并發(fā)癥。結(jié)果34例患者胸悶、胸痛、氣促、呼吸困難等癥狀緩解,其中:1例患者在腹部皮下注射處出現(xiàn)1 cm×2 cm的血腫;2例患者橈動脈穿刺處出現(xiàn)1 cm×1 cm的血腫,經(jīng)紗布填塞1 h后,血腫均未見增大,7 d后逐漸吸收;3例患者出現(xiàn)鼻出血,量約30 ml,經(jīng)紗布填塞后停止出血;2例患者血壓為75~80/50~55 mmHg(1 mmHg=0.133 kPa),經(jīng)升壓等急救和護(hù)理后均好轉(zhuǎn);2例患者病死。結(jié)論急性大面積肺栓塞患者靜脈溶栓治療期間,及時發(fā)現(xiàn)病情變化及出血等不良反應(yīng),積極配合搶救,可提高搶救成功率。
[Abstract]:Objective to explore the nursing methods of patients with acute large area pulmonary embolism treated by intravenous thrombolysis. Methods the clinical data of 36 patients with acute large area pulmonary embolism treated by cardiopulmonary circulation department of Shanghai Lung Hospital affiliated to Tongji University in 2015 were analyzed retrospectively. All patients were treated with atepinase for intravenous injection of microinjection pump. Before, during and after thrombolysis, symptomatic nursing and specialized nursing of pulmonary vascular disease were carried out. The vital signs of the patients and the skin at the puncture site were closely observed. Blood routine, coagulation time and other laboratory tests, timely detection of bleeding and other complications. Results the symptoms of chest tightness, chest pain, shortness of breath and dyspnea were relieved in 34 patients. Among them, 1 patient had 1 cm 脳 2 cm hematomas at the subcutaneous injection of abdomen. There were 1 cm 脳 1 cm hematomas at the puncture site of radial artery in 2 patients. After filling with gauze for 1 hour, the hematomas did not increase and gradually absorbed after 7 days, and nasal bleeding occurred in 3 patients, which stopped bleeding after gauze packing for about 30 ml,. The blood pressure of 2 patients was 75 鹵80 鈮，

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