肝腹水患者腹腔穿刺放腹水的护理
时间:2011-08-19 13:42 作者:中华肝病网
肝硬化腹水俗称肝腹水。正常人腹腔内有少量的游离腹水,一般为50毫升左右,起着维持脏器间润滑作用,当腹腔内出现过多游离液体时,称为肝腹水。
腹水是肝硬化患者最突出的临床表现,主要是由于门静脉压增高及血浆白蛋白降低等因素引起。肝硬化失代偿期患者75%以上出现腹水,大量的腹水可出现呼吸困难、心悸、下肢水肿、脐疝,腹部膨隆呈蛙状腹,给患者带来心理和生理的不适,良好的护理对此病的预后起着重要作用。
肝腹水患者的,腹腔穿刺放腹水的护理
1、应督促肝腹水患者术前排尿,以免损伤膀胱
2、肝腹水患者取舒适的坐位或半卧位
3、术中随时观察肝腹水患者的脉搏、呼吸及面色改变,如有面色苍白、恶心、心慌等表现,应立即停止放液,并扶患者平卧于床上,给予对症处理。
4、放液速度不宜过快,量不宜过多,每次不超过2000—3000ml。
5、放腹水毕,嘱患者卧床休息8—12h,详细记录穿刺部位、时间、腹水量、性状、患者情况等。
6、注意穿刺孔有无渗液,如有腹水渗出,可用无菌塞子压迫固定。防止局部感染。
术后密切观察患者的病情变化,再测量一次患者的体重、腹围,并用腹带将腹部包扎紧,以免肝腹水患者因腹压降低而使腹水迅速生成。
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