| 急性下肢缺血性疾病截肢术后的临床护理 |
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| 引用本文： | 王娜娜,师堂旺,韩梅,宗晓玲.急性下肢缺血性疾病截肢术后的临床护理[J].中华全科医学,2017,15(9):1623-1625. |
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| 作者姓名： | 王娜娜 师堂旺 韩梅 宗晓玲 |
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| 作者单位： | 1. 蚌埠医学院第一附属医院小儿外科, 安徽 蚌埠 233004; |
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| 摘 要： | 目的 探讨因急性下肢动脉缺血导致足趾坏死行截肢手术患者术后的临床护理方法。 方法 回顾性分析2015年1月—2016年1月蚌埠医学院第一附属医院血管外科收住的18例因急性下肢动脉缺血导致足趾坏死行截肢治疗患者术后的临床护理资料,护理上包括积极的心理疏导、残端创面的精心护理、饮食健康指导、康复训练等,一期愈合不良的创面经过一段时间清创待新鲜肉芽组织生长后行负压封闭引流1周,观察术肢残端愈合及患者恢复情况。 结果 本组12例患者术后残端创面一期愈合;5例患者术后创面发生脂肪液化,部分切缘不愈合,加强换药联合负压封闭引流术,二期缝合;3例患者术后出现肺部感染,4例患者术后出现心衰症状;经综合治疗与护理,17例患者残端伤口均愈合,肢体功能锻炼良好,肺部感染、心衰症状得到有效控制,餐后血糖均控制在9.0 mmol/L以下,1例高龄患者术后4 d发生心肺功能衰竭死亡。 结论 下肢缺血性疾病导致足趾坏死截肢术后需要配合安全、精心的护理与健康饮食指导,对促进患者康复、创面愈合、减少并发症、提高患者生活质量有着重要意义。
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| 关 键 词： | 急性下肢动脉缺血 截肢 负压封闭引流技术 护理 |
| 收稿时间： | 2016-03-16 |
Clinical nursing care of patients with lower limb ischemic disease after amputation |
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| Affiliation: | 1. Department of Pediatric Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China |
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| Abstract: | Objective To investigate the clinical nursing experience of patients with amputation of toe necrosis after surgery because of acute lower limb ischemia. Methods The nursing data of 18 cases with toe necrosis and amputation as a result of acute arterial ischemia of the lower extremity who were admitted to the First affiliated hospital of Bengbu medical college, department of vascular surgery from January, 2015 to January, 2016, were retrospectively analyzed, including positive psychological counseling, intensive care of the amputation ending, a healthy diet instruction and rehabilitation training. The undesirable wound surface of the first stage was treated via a period of debridement for fresh granulation tissue growth and then underwent vacuum sealing drainage (VSD) for one week. The healing of the amputation ending as well as the patients' recovery was observed. Results There were twelve patients with amputated wounds who were healed in the first stage, five patients who suffered from postoperative fat liquefaction, partly with unhealed incisal margin, after strengthening medicine combined with VSD and sutured in the second stage, three patients suffered from pulmonary infection, four cases patients had heart failure symptoms. After comprehensive treatment and nursing, seventeen cases of patients with amputation wound healed, limb functional exercise is good, pulmonary infection, heart failure symptoms get effective control and postprandial blood glucose levels were below the 9. 0 mmol/L. One case of elderly patient died of heart and lung failure four days after operation. Conclusion The patients with toes amputation surgery because of the acute arterial ischemia of the lower extremity need to cooperate with security, careful nursing and diet health guidance, which is of great significance to promote the rehabilitation, wound healing, reduce complications and improve the quality of life of the patients. |
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