Marchigiano Gail, Riendeau Debra, Jo Morse Carol
Saint Joseph's College of Maine, 278 Whytes Bridge Road, Standish, ME 04084, USA.
Crit Care Nurs Q. 2006 Oct-Dec;29(4):312-23; quiz 324-5. doi: 10.1097/00002727-200610000-00004.
Treatment of deep vein thrombosis traditionally has focused on preventing the potentially life-threatening complication of pulmonary embolism rather than on removing or reducing the thrombus. Although treatment with anticoagulants may prevent thrombus propagation, the body's intrinsic thrombolytic system is left to attempt clot dissolution. Because this natural process is generally ineffective in its ability to fully recanalize a proximal vein, the risks of recurrent thrombosis as well as the disabling complication of postthrombotic syndrome increase. Moreover, the long-term consequences of postthrombotic syndrome include pain, disability, and, for many, a significant decrease in the quality of life. Recent technology using high-frequency, low-power ultrasound, or mechanical thrombectomy with catheter-directed delivery of a thrombolytic drug directly into the clot is available and showing promise. Nurses are caring for patients who receive endovascular interventions with lytic infusions. The nursing challenge is to provide safe and effective patient care.
传统上，深静脉血栓形成的治疗重点在于预防肺栓塞这一潜在的危及生命的并发症，而非清除或减少血栓。尽管使用抗凝剂治疗可防止血栓扩散，但人体自身的溶栓系统仍需尝试溶解血栓。由于这一自然过程通常在使近端静脉完全再通方面效果不佳，复发性血栓形成的风险以及血栓形成后综合征这一致残性并发症的风险都会增加。此外，血栓形成后综合征的长期后果包括疼痛、残疾，对许多人来说，还会导致生活质量显著下降。目前已有使用高频、低功率超声的最新技术，或通过导管将溶栓药物直接输送至血栓处进行机械性血栓切除术，且这些技术已显示出前景。护士正在护理接受溶栓输注的血管内介入治疗的患者。护理工作面临的挑战是提供安全有效的患者护理。
