目的 急性Stanford A型主动脉夹层(AAAD)患者往往需急诊手术,以挽救其生命。手术通常存在高风险。术后常见并发症包括:神经系统、呼吸系统、胃肠道、肝、肾脏等多器官系统的功能障碍,以及全身感染,其使得术后过程更加复杂。 因此, 围术期护理极为重要。方法 2016年2月—2018年2月, 共完成了24 例 AAAD患者的手术。术前所有病人收治科室ICU。手术方式为Bentall+Sun'氏术。 围术期,对患者随机分组进行密切观察和护理。A组:常规组(routine nursing):对患者给予常规护理;B组:整体组(integrated nursing):除了常规的基本护理外,加强了围术期镇静、镇痛和术后并发症的专业化的整合护理。结果 两组共24例成功完成了手术。两组术前资料比较,无显著差异。整体护理组ICU停留时间和住院时间短于常规组(P<0.05);护理满意度、生活质量比较,整体组患者优于常规组(P<0.05)。结论 护士提供的围术期专业化技术的整体护理,可改善患者围术期的治疗效果,促进康复。

目的 对比双腔耐高压PICC和股静脉置管在IV级心力衰竭患者中的应用效果。方法 选取我院 2016年1月—12月收治的端坐位IV级心力衰竭患者61例,按照便利抽样的方法将其随机分成研究组31例和对照组30例。研究组患者行耐高压PICC置管,对照组患者行双腔中心股静脉置管,观察2组患者的一次性置管成功率、导管头端位置、并发症发生率、留置导管天数和患者满意度等相关临床指标。结果 研究组患者的一次插管成功率为 93.55%(29例),高于对照组的83.33%(25例)(P<0.05);研究组患者的并发症发生率低于对照组(P<0.05)。结论 对IV级心力衰竭患者在端坐位下予以耐高压PICC 插管进行治疗,能提高一次置管成功率,降低并发症发生率,提高患者满意度,可作为患者抢救时的首选静脉通道。

Objective To compare the effect of dual chamber high pressure PICC (peripherally inserted central catheter) and femoral vein CVC(central venous catheter)catheterization in patients with IV class heart failure. Methods From January to December 2016, 61 patients with congestive heart failure in the sitting position were selected from our hospital. According to the convenient sampling method, they were randomly divided into the study group (31 cases) and the control group(n=30). The study group were treated with high pressure PICC tube, the control group underwent femoral vein catheterization. Two groups of patients with the success rate of catheterization, catheter tip location, complications, indwelling catheter days and related clinical indicators of patient satisfaction were observed. Results The successful rate of intubation in the study group was 93.55% (29 cases), higher than that of the control group (25 cases)(P<0.05), and the incidence of complications in the study group was lower than that of the control group(P<0.05)(83.33%). Conclusion Treatment for patients with heart failure IV be in sitting position under high pressure PICC intubation, may improve the success rate of catheterization, reduce the incidence of complications, improve patient satisfaction, and be the first choice when the rescue of patients with venous channel.