[1]余洁静,鲁娟,张中月.长期接受抗凝治疗患者的骨科手术围手术期护理[J].中医正骨,2015,27(03):79-80.
点击复制

长期接受抗凝治疗患者的骨科手术围手术期护理()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年03期
页码:
79-80
栏目:
骨伤科护理
出版日期:
2015-03-30

文章信息/Info

作者:
余洁静; 鲁娟; 张中月
温州医科大学附属第二医院,浙江 温州 325027
关键词:
围手术期护理;  抗凝药
摘要:
目的:探讨长期接收抗凝治疗患者的骨科手术围手术期护理方法。方法:2009年6月至2014年6月,采用包括出血护理、原发疾病护理、药物应用护理、手术护理等措施的系统护理方法,规范护理长期接受抗凝治疗的骨科手术患者46例,男29例,女17例。年龄56～89岁,中位数72岁。冠状动脉支架或搭桥术后17例、心脏瓣膜置换术后11例、脑卒中后15例、下肢静脉栓塞3例。合并糖尿病15例,高血压20例。下肢骨折切开复位内固定术26例、关节置换术9例、上肢骨折切开复位内固定术11例。观察手术完成、原发疾病复发及并发症发生情况。结果:所有患者均顺利完成手术,安全渡过围手术期; 均未出现原发疾病加重或复发。2例切口引流血性液体超过1500 mL,给予夹闭引流管和应用止血药物治疗后好转。均无下肢深静脉血栓形成等并发症发生。结论:科学规范的围手术期护理有助于手术顺利完成,防止原发疾病加重或复发,减少并发症的发生,使患者安全渡过围手术期。

参考文献/References:

[1] Wysokinski WE,McBane RD,Daniels PR,et al.Periprocedural anticoagulation management of patients with nonvalvular atrial fibrillation[J].Mayo Clinic Proc,2008,83(6):639-645.
[2] James D,Alex C,Frederick A,et al.Perioperative management of antithrombotic therapy:Antithrnmbotic therapy and prevention of thrombosis,9th ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J].2012,141(2 suppl):326-350.
[3] Kovacs MJ,Kearon C,Rodger M,et al.Single-arm study of bridging therapy with low-molecular-weight heparin for patients at risk of arterial embolism who require temporary interruption of warfarin[J].Circulation,2004,110(12):1658-1663.
[4] Larson BJ,Zumberg MS,Kitchens CS.A feasibility study of continuing dose-reduced warfarin for invasive procedures in patients with high thromboembolic risk[J].Chest,2005,127(3):922-927.
[5] Douketis JD,Johnson JA,Turpie AG.Low-molecular-weight heparin as bridging anticoagulation during interruption of warfarin:assessment of a standardized periprocedural anticoagulation regimen[J].Arch Intern Med,2004,164(12):1319-1326.
[6] 张孝静,傅武平.老年髋部骨折术后抗凝治疗的临床观察及护理[J].中医正骨,2013,25(5):76.
[7] 万华,罗漫丽,魏润玲.股骨近端防旋髓内钉治疗合并阿尔茨海默病的股骨转子间骨折的围手术期护理[J].中医正骨,2014,26(1):77-78.
[8] Ansell J,Hirsh J,Hylek E,et al.Pharmacology and management of the vitamin K antagonists:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines(8th Edition)[J].Chest,2008,133(6 Suppl):160-198.

相似文献/References:

[1]易春智,陈锦伦,李肇宏,等.利伐沙班与依诺肝素钠对髋膝关节置换术后 下肢深静脉血栓形成及围手术期隐性失血的影响[J].中医正骨,2016,28(01):17.
　YI Chunzhi,CHEN Jinlun,LI Zhaohong,et al.Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):17.
[2]何雪花.快速康复外科理念在膝关节镜手术围手术期护理中的应用[J].中医正骨,2017,29(02):79.

备注/Memo

备注/Memo:
2014-09-22收稿 2014-11-19修回
更新日期/Last Update: 2015-03-30