主动脉夹层护理教学ppt课件

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1、主动脉夹层动脉瘤患者的护理主动脉夹层动脉瘤疾病简介DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital在主动脉壁存在或不存在自身病变的基础上，并在一系列可能外因的作用下导致主动脉内膜撕裂，血液由内膜撕裂口进入主动脉壁中层，造成主动脉中层沿长轴分离，从而使主动脉管腔呈现真假两腔的一种病理状态。定义DepartmentofCardiology

2、,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital名词解释真腔：主动脉原有的管腔称为真腔；假腔：主动脉壁分离形成的管腔称为假腔；夹层隔膜：位于真假腔之间，被撕裂的内膜和中膜的内1/3层称为夹层隔膜；动脉瘤：病变动脉的直径大于正常动脉1.5倍者称动脉瘤。夹层动脉瘤属于假性动脉瘤的范畴夹层裂口：内膜的破口称为夹层裂口。DepartmentofCardiology,CardiacCar

3、eUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital特点发病急发展快死亡率高心血管外科最凶险的疾病DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital病因1.高

4、血压：急性主动脉夹层75%合并有高血压;2.遗传因素：常有家族聚集倾向;3.主动脉内膜损伤：高处坠落、突然刹车或撞车;4.妊娠：后期弹力纤维脆弱、全身血容量增加、血流张力增加;5.先天性心血管疾病：马凡综合征等6.其它：梅毒性主动脉炎、心内膜炎。DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital分型A型：无论夹层起源于哪一部位，只要累及

5、升主动脉者称为A型；B型：夹层起源于降主动脉且未累及升主动脉者称为B型。DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospitalstanford分型DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospit

6、alofNanjingMedicalUniversityJiangsuProvinceHospitalstanford分型DeBakey分型I型:夹层分离遍及升主动脉、主动脉弓降主动脉及腹主动脉；Ⅱ型:夹层分离限于升主动脉；Ⅲ型:夹层分离限于胸主动脉(Ⅲa)或延及腹主动脉(Ⅲb)DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospitalDeBa

7、key分型DepartmentofCardiology,CardiacCareUnitCardiovascularMedicalCenterofJiangsuTheFirstAffiliatedHospitalofNanjingMedicalUniversityJiangsuProvinceHospital临床表现1.疼痛：多为撕裂样或刀割样疼痛；2.高血压：难以控制的高血压；3.脏器缺血表现：神经系统：偏瘫、截瘫一过性脑缺血；四肢缺血：肢体发凉、紫绀、脉搏消失；肾脏缺血：尿少、