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目的探讨个体化组合分支支架重建主动脉弓治疗术并发症预防康复的有效护理方式。方法选取2014年1月—2015年12月安徽省省立医院收治的44例Stanford A型主动脉夹层患者为研究对象,实施个体化组合分支支架重建主动脉弓术,随机分为对照组22例,行常规护理;观察组22例行精细化系统化综合护理干预,观察两组患者术后并发症发生恢复情况、平均住院日和护理满意度。结果患者术后出现2例死亡病例,对照组和观察组各1例。对照组患者术后早期出现并发症8例(36.36%),观察组患者术后早期出现并发症7例(31.82%),术后早期并发症的发生率差异无统计学意义(P>0.05),但观察组患者术后早期并发症康复例数7例(33.33%)高于对照组4例(19.05%)。在住院治疗中,对照组迟发并发症(术后5 d后出现的并发症)6例(28.57%),观察组2例(9.52%),两组比较差异有统计学意义(P<0.05)。对照组术后平均护理满意度为85.71%,观察组为95.24%,患者满意度得到提高(P<0.05),平均住院日下降。结论精细的综合护理干预,可在一定程度上降低个体化组合分支支架重建主动脉弓术治疗Stanford A型主动脉夹层患者的并发症发生概率,促进术后并发症的康复,提升患者的临床满意度,值得进一步在临床护理中推广。
OBJECTIVE: To explore an effective nursing method for the reconstruction of aortic arch by individualized combined stent-graft for the prevention and treatment of complications. Methods Forty-four patients with Stanford type A aortic dissection admitted to Anhui Provincial Hospital from January 2014 to December 2015 were enrolled in this study. Individualized combined stent-graft was used to reconstruct aortic arch, which were randomly divided into control group (n = 22) Routine care; observation group of 22 patients underwent systematic and comprehensive nursing intervention to observe the recovery of postoperative complications in both groups, the average length of stay and nursing satisfaction. Results There were 2 deaths in the patients and 1 in the control group and the observation group. In the control group, 8 cases (36.36%) had early postoperative complications, 7 cases (31.82%) had early postoperative complications in the observation group, and there was no significant difference in the incidence of early postoperative complications (P> 0.05) , But the number of cases with early complications in observation group was higher than that in control group (33.33%) in 4 cases (19.05%). In hospitalized patients, there were 6 cases (28.57%) in the control group and 2 cases (9.52%) in the control group with delayed complications (complications after 5 days), the difference between the two groups was statistically significant (P <0.05 ). The average postoperative nursing satisfaction was 85.71% in the control group and 95.24% in the observation group. The patient satisfaction was improved (P <0.05) and the average length of stay was decreased. Conclusion The intensive comprehensive nursing intervention can reduce the probability of complication of patients with Stanford type A aortic dissection by individualized combined stent-graft, promote the rehabilitation of postoperative complications, and improve the clinical satisfaction of patients, Worth further promotion in clinical nursing.