1例原发性血小板增多症继发门静脉海绵样变及上消化道出血的护理

发布时间：2018-01-10 19:22

本文关键词：1例原发性血小板增多症继发门静脉海绵样变及上消化道出血的护理　出处：《中华护理杂志》2017年11期 　论文类型：期刊论文

【摘要】：总结1例原发性血小板增多症继发门静脉海绵样变及上消化道出血患者的护理经验。护理要点:依托多学科团队合作,做好上消化道出血紧急救护同时重视肠道护理,降低肝性脑病的发生率;充分识别术后抗凝的风险,采取预防性护理干预措施;规范门静脉测压管护理,动态监测门静脉压力变化;机械通气期间采取镇痛为先的浅镇静方案,开展早期活动方案,预防ICU获得性衰弱的发生;出院后通过长期随访管理,提升患者的远期生活质量。
[Abstract]:To summarize the nursing experience of a patient with primary thrombocytopenia secondary portal cavernous change and upper gastrointestinal hemorrhage. Nursing essentials: relying on multidisciplinary teamwork. In order to reduce the incidence of hepatic encephalopathy, the emergency rescue of upper digestive tract hemorrhage should be paid more attention to the nursing of intestinal tract at the same time. Fully identify the risk of postoperative anticoagulant, take preventive nursing intervention measures; The nursing of portal vein manometry tube was standardized and the change of portal vein pressure was monitored dynamically. In order to prevent the occurrence of ICU acquired weakness, we should take the shallow sedation scheme of analgesia first and carry out early activity plan during mechanical ventilation. The long-term quality of life of patients was improved by long-term follow-up management after discharge.
【作者单位】：浙江大学医学院附属第二医院肝胆胰外科;浙江大学医学院附属第二医院重症监护室;
【分类号】：R473.5
【正文快照】： 原发性血小板增多症(essential thrombocythae-mia,ET)是一种Ph染色体阴性的慢性骨髓增殖性肿瘤,其特征为血小板计数增多以及与之相关的血栓形成和出血[1]。有文献[2]报告,ET患者由于血液粘稠度增高,血栓的发生率高达50%~70%。若血栓发生在门静脉,可引起管腔狭窄、血流速度减

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