腹主动脉瘤腔内隔绝术护理

腹主动脉瘤是腹主动脉某一段的异常扩张或膨胀,90％以上是由于动脉粥样硬化引起的,并存心、肺、肝、脑、肾功能不全,发病率达2％-6．6％。随着社会的老龄化,老年患者越来越多,症状性腹主动脉瘤得到诊断后的2年内自然破裂率达50％, 高自然破裂率和高手术死亡率都对病人造成很大的威胁。     

腹主动脉瘤腔内隔绝术的护理

自１９９７年３月－１９９８年５月,９例高龄腹主动脉瘤并存心,肺,肾等疾病的中层得施行了腹主动脉瘤腔内隔绝术取得成功。     

覆膜支架腔内隔绝术治疗腹主动脉瘤患者的围手术期护理

腹主动脉瘤是由于动脉壁破裂变性后形成永久性异常膨胀、扩张、屈曲延长,是一种常见的动脉扩张性疾病。临床上把位于肾动脉水平以上的腹主动脉瘤称为胸腹主动脉瘤,而将位于肾动脉水平以下的称为腹主动脉瘤[1]262-307。早期诊断、早期治疗是降低该病死亡率的唯一有效手段。由于腔内隔绝术治疗创伤小、恢复快、愈后效果满意,目前成为治疗肾下型腹主动脉瘤的首选方法。我院2005~2006年对23例腹主动脉瘤患者进行覆膜支架腔内隔绝术,疗效满意,现将护理体会报告如下。1临床资料1.1一般资料本组23例,男性17例,女性5例,年龄34~83岁。临床表现腹痛并伴有腹部搏动性包块13例;表现为腹部不适、饱满感、食欲下降者5例;其中15例合并高血压病史;无症状5例。术前破裂死亡2例,保守治疗1例,其余20例全部治愈出院。本组患者均经过CT、腹部B超明确诊断,动脉瘤直径在4.5~8 cm。1.2手术过程麻醉成功后,常规消毒铺巾,行左侧股动脉穿刺,置5 F动脉鞘,泥鳅导丝导引黄金标记导管至腹主动脉肾动脉分支上方,高压造影测量腹主动脉瘤直径、长度,瘤颈长度,至双髂动脉分叉距离。取右侧腹股沟切口,逐层切开,暴露并控制右股动脉,全身肝素化后,交换...     

腔内隔绝术治疗腹主动脉瘤的护理

总结6例腹主动脉瘤患者行腔内隔绝术治疗的护理.护理重点为术前做好心理护理,防止腹主动脉瘤破裂,注意观察血压及双下肢血运变化;术后严密观察生命体征、肢体血运,注意有无出血倾向,重视肾功能、内漏的观察.经治疗及护理,6例患者治愈出院,未发生并发症.     

腹主动脉瘤手术后的护理

腹主动脉瘤主要是动脉粥样硬化等原因使动脉壁的结构失去正常的完整性，血管腔狭窄所致的血流漩涡，在狭窄部位血流增速，对血管壁的冲击压力增大，使血管扩张而形成。临床上较少见，多为高龄患者，手术难度大，危险性高。我院于1987年～1997年12月收治肾动脉下腹主动脉瘤5例，均行动脉瘤切除，人造血管移植术，现将术后护理体会报告如下。1临床资料患者5例，均为男性，年龄50～65岁，其中1例动脉瘤破裂，因拒绝手术而延误，术中死亡;1例术后1年零百个月因全身感染死亡，3例健在。2护理要点2.1体位护理：患者术后应送ICU，连接各种监护仪…     

微创腹主动脉瘤腔内隔绝术护理体会

通过对11例接受腹主动脉瘤腔内隔绝术（微创）腹主动脉瘤患者的术中护理配合分析,认为术中护理要点在于密切监测各项生命体征,正确使用肝素,熟悉介入手术的概念和导管,导丝性能的重要性,这是保证手术顺利实施的重要保证。     

血管腔内覆膜支架植入术治疗腹主动脉瘤的护理

目的 总结血管腔内覆膜支架植入术治疗腹主动脉瘤患者围手术期并发症的预防、观察和临床护理要点.方法 对2008年1-8月行血管腔内覆膜支架植入术治疗的27例腹主动脉瘤患者的临床资料进行回顾性分析.结果 27例手术均获成功,术后未发生严重并发症,治疗及护理效果良好.结论 有效的护理措施是保证治疗成功的重要因素.     

腹主动脉瘤腔内隔绝术2例护理体会

近年来，我们应用分叉型人造血管一内支架复合体腔内隔绝治疗腹主动脉瘤2例，取得满意效果，现将护理体会报告如下。     

腹主动脉瘤腔内隔绝术的护理

自１９９７年３月～１９９８年５月,为９例高龄腹主动脉瘤并存心、肺、肾等疾病的患者施行了腹主动脉瘤腔内隔绝术取得成功。本文报告术前的心理护理及针对病人的具体情况,做好必要的解释,各种检查的准备,控制和改善病人的全身情况,选择合适型号的内支撑—人造血管复合体,术后生命体征和足背动脉搏动的观察,抗凝和祛聚药的应用,有效的止痛和康复指导。     

腔内隔绝术治疗腹主动脉瘤患者的术中护理

目的探讨腹主动脉瘤腔内隔绝术的术中配合、护理措施及防治并发症发生的方法。方法对72例接受覆膜支架腔内隔绝术的患者进行回顾性分析,包括术前准备、术中配合与监护,并针对各自的并发症实施相应的预防护理。结果72例患者介入手术成功率100％。结论准确的术前决策,充分的术前准备,术中娴熟的操作技术配合及严密监护,对发生的异常情况进行分析并迅速采取护理措施,是手术顺利进行、减少并发症、提高手术成功率和抢救成功率的重要保证。     

Postoperative radiology of endovascular abdominal aortic aneurysm repair.

This article addresses the imaging appearances following endovascular abdominal aortic aneurysm repair (EVAR). EVAR is gaining popularity and hence there is increasing likelihood that radiologists who are unfamiliar with the procedure will report imaging investigations on these patients. We describe the technique, failure modes, complications, and postoperative imaging features of this procedure.     

10例老年腹主动脉瘤人工血管重建术术后并发症观察与护理

目的探讨老年腹主动脉瘤人工血管重建术术后并发症的观察与护理要点。方法对10例老年腹主动脉瘤人工血管重建术术后的患者,其并发症发生情况进行分析和总结。结果 10例患者术后并发出血2例,急性心肌梗死1例,心律失常5例,呼吸功能不全4例,肾功能不全3例,不完全性肠梗阻2例,经严密观察和及时治疗,均痊愈出院。结论老年患者人工血管重建术术后并发症发生率高,加强术后观察并及时处理,是提高手术成功率、保障患者痊愈的关键。     

Postoperative mobilization of patients with abdominal aortic aneurysm

AIM: This paper reports on a study which aimed to evaluate the effects of structured written preoperative information on patients' postoperative psychological and physical wellbeing after surgery for abdominal aortic aneurysm (AAA). BACKGROUND: The possible benefits of current booklets written by professionals on postoperative psychological and physical wellbeing in patients with AAA are unknown. Previous studies have shown that preoperative information has a favourable effect on both mood state and physical mobilization. METHOD: Fifty-two patients admitted for elective repair of AAA were selected consecutively and randomized to receive only verbal (control group), or verbal and written information in booklet form (experimental group). The booklet contained procedural and sensory information about the disease and its treatment. Two questionnaires were used to establish whether the booklet had any effect on perceived health, psychological and physical wellbeing postoperatively. RESULTS: The two groups were similar regarding their perceived health but differed significantly regarding psychological wellbeing pre- and postoperatively. Patients in the experimental group were significantly sadder both pre- and postoperatively compared with those in the control group. Both groups were similar in postoperative physical wellbeing. CONCLUSION: This group of patients often has asymptomatic disease, with a short interval between diagnosis and major surgery. When patients receive an information booklet during this period, this seems to cause more worries than anticipated. Hence, a more supportive educational programme might benefit this patient group, both pre- and postoperatively.     

腔内隔绝术治疗腹主动脉瘤病人的护理

腹主动脉瘤(AAA)是指各种原因造成的腹主动脉管壁局部薄弱,张力减退后伸延所产生的永久性异常扩张或膨出,多发生于中老年人.我科2040年10月-12月收治了3例AAA病人,均康复出院.现将动脉瘤腔内隔绝术治疗腹主动脉瘤的护理体会介绍如下.……     

Surveillance after endovascular abdominal aortic aneurysm repair

(EVAR) Endovascular Aneurysm Repair of abdominal aortic aneurysms have mandated the need for surveillance imaging and other follow-up testing to minimize the complications of endograft failure and potential for abdominal aortic aneurysms rupture. The 2-dimensional and 3-dimensional contrast-enhanced computed tomography imaging currently serves as the gold standard for serial (EVAR) Endovascular Aneurysm Repair assessment, but this recommendation is being modified by successful clinical experience using duplex ultrasound, magnetic resonance imaging, and implantable wireless sac pressure sensors. Nearly all stent graft devices and abdominal aortic aneurysm-related complications after (EVAR) Endovascular Aneurysm Repair can be detected using available surveillance modalities assuming a compliant patient during follow-up. Alternating complementary surveillance techniques (contrast and noncontrast computed tomography, ultrasound, and pressure measures) can be used to reduce contrast dye and radiation exposure and can be tailored to patients with chronic renal insufficiency.     

Ruptured abdominal aortic aneurysm: endovascular treatment

Background This report describes our preliminary experience in endovascular management of 25 ruptured abdominal aortic aneurysms (rAAAs).Methods In the past 3 years we treated 46 patients who had rAAA, and 25 (54.3%) were treated with an endovascular approach. Patients’ mean age was 76 ± 9 years. The diagnosis was confirmed by computed tomographic angiography in 23 patients (92%). Mean aneurysm diameter was 73 ± 17 mm. We used an infrarenal bifurcated device in 17 patients (68%), a suprarenal bifurcated in four patients (16%), and an aortomonoiliac graft in four patients (16%). Overall, nine patients (36%) required intensive care. Every patient underwent radiologic follow-up according to the Eurostar register, with concomitant evaluation of the D-dimer level (cut-off <200 μg/L) as a biological marker for endoleaks.Results The primary technical success rate was 100%. Overall in-hospital mortality rate was 20%. Mean hospitalization was 7 days (range, 3–30), and mean follow-up was 7 months. One occlusion (4%) of the iliac limb and two type II endoleaks (8%) occurred. The mean D-dimer level in type I endoleak was 1045 μg/L (range, 459–2021).Conclusions In our experience, endovascular management of rAAA is feasible and safe and produces better results than conventional surgery, provided the morphology is suitable and the procedure is carried out by an experienced endovascular team.     

Imaging after endovascular repair of abdominal aortic aneurysm

Endovascular repair of abdominal aortic aneurysm is a less invasive alternative to open surgery. With the recognition of this new treatment, however, many complications, some of them life-threatening, have been reported. Short-term and mid-term results have shown that this technology is advancing and needs close follow-up. Imaging plays a major role in the evaluation of the aorta after endolumenal repair. This article reviews the roles of different imaging techniques.     

Abdominal aortic aneurysm treated by endovascular surgery: a case report

An aneurysm is an abnormal dilation or irreversible convex of a portion of an artery. The most common site of aneurysms is the abdominal aorta and their appearance is often due to degeneration of the arterial wall, associated with atherosclerosis and favored by risk factors such as smoking and hypertension, among others. Left untreated, aneurysm of the abdominal aorta usually leads to rupture. Treatment is surgical, consisting of the introduction of a prosthesis, composed basically of a stent and an introducer, into the aorta. We report the case of a person diagnosed with abdominal aortic aneurysm in a routine examination who was admitted for ambulatory surgical treatment. We designed a nursing care plan, following Virginia Henderson's conceptual model. The care plan was divided into 2 parts, a first preoperative phase and a second postimplantation or monitoring phase. The care plan contained the principal nursing diagnoses, based on the taxonomies of the North American Nursing Diagnosis Association (NANDA), nursing interventions classification (NIC) and nursing outcomes classifications (NOC), and collaboration problems/potential complications. The patient was discharged to home after contact was made with his reference nurse in the primary health center, since during the hospital phase, some NOC indicators remained unresolved.     

Resuscitation for an octogenarian with ruptured abdominal aortic aneurysm using endovascular balloon

Ruptured abdominal aortic aneurysm is a true emergency for emergency physicians and surgeons. Achieving effective proximal control may ameliorate further hemodynamic deterioration and buy time for patients awaiting further repair. An 82-year-old man was referred to our hospital with shock resulting from a ruptured abdominal aortic aneurysm. At the moment of impending cardiac arrest, aortic occlusion was achieved with a transfemoral endovascular balloon, without fluoroscopic guidance. The octogenarian then underwent a prosthetic graft reconstruction and recovered well. In this report, the safeguards and pitfalls of aortic occlusion using an endovascular balloon are discussed. This procedure is not only effective in vascular control but also valuable in resuscitation.