累及弓部分支的B型主动脉夹层患者原位开窗腔内治疗的护理

目的探讨累及弓部分支的Stanford B型主动脉夹层患者原位开窗腔内治疗的临床护理对策。方法回顾性分析解放军总医院血管外科2012年1月至2013年7月收治的9例累及弓部分支的B型主动脉夹层近端锚定区不足患者采用腔内原位开窗技术治疗的临床资料,总结护理要点。结果所有患者支架置入均一次成功,夹层原发破口完全封闭,无内漏发生,围术期无死亡病例。1例患者出现声音轻微嘶哑,其余患者无相关并发症发生。9例患者的平均住院天数为(12±2)d,均痊愈出院。结论加强累及弓部分支的Stanford B型主动脉夹层近端锚定区不足患者原位开窗腔内治疗的围术期护理,有助于提高患者的手术耐受性、有效预防并发症的发生。

Nursing Experience of Orthotropic Fenestrated Endovascular Repair of Type B Aortic Dissection involving Aortic Arch

Objective To explore the nursing option and efficiency of in situ fenestrated thoracic endovas-cular aortic repair （TEVAR）of type B aortic dissection involoving aortic arch.Methods The clinical date of 9 patients with type B thoracic aortic dissection involving aortic arch with hostile aortic proximal landing anatomy treated by TFEVAR from January 2012 to July 2013 was retrospectively analyzed and summarized the nursing key point and effective measure.Results The primary technical success rate was 100%.The perioperative end leak rate and mortality were all 0%.There is only 1 hoarseness case,and other patients had no incidence of related complications.The average hospitalization days were 12＆#177;2 days.Conclusion Enhancing perioperative nursing of in situ fenestrated TEVAR of type B aortic dissection involving aortic arch can effectively improve patient’s tolerance of the surgery and prevent the incidence of complication.