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Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,/10/29,*,原发性下肢静脉曲张的护理,1,.,2024/8/28,原发性下肢静脉曲张的护理1.2023/9/5,定义,原发性下肢静脉曲张是指下肢浅静脉瓣膜关闭不全,使静脉内血流倒流,远端静脉瘀滞,继而病变静脉壁扩张、变性、出现不规则膨出和扭曲。,多发生于体力劳动强度大、从事久站工作,或久坐少动人群。,2,.,2024/8/28,定义 原发性下肢静脉曲张是指下肢浅静脉瓣膜关闭不全,使,【病因】,1、先天因素,静脉瓣膜缺陷和静脉壁薄弱是全身支持组织薄弱的一种表现,与遗传有关。,2、后天因素,增加下肢静脉瓣膜承受压力和循环血量超负荷是造成下肢静脉曲张的后天因素,如长期站立、重体力劳动、妊娠、慢性咳嗽、习惯性便秘等。,3,.,2024/8/28,【病因】 1、先天因素 静脉瓣膜缺陷和静脉壁薄弱是全,症状,患肢小腿感觉沉重、酸胀、乏力。,体征,下肢浅静脉扩张、隆起和迂曲。后期出现足靴区皮肤营养不良,皮肤色素沉着、湿疹和溃疡形成,。,【临床表现】,4,.,2024/8/28,症状【临床表现】4.2023/9/5,5,.,2024/8/28,5.2023/9/5,【辅助检查】,特殊检查,大隐静脉瓣膜功能试验,(,t,rendelenburg test),深静脉通畅试验(,p,erthes test),交通静脉瓣膜功能试验(,p,ratt test),影像学检查,下肢静脉造影,血管超声检查,6,.,2024/8/28,【辅助检查】 特殊检查 影像学检查6.2023/9/5,【,常见护理诊断/问题,】,1、活动无耐力,与下肢静脉回流障碍有关。,2、皮肤完整性受损,与皮肤营养障碍、慢性溃疡有关。,3、潜在并发症,深静脉血栓形成、小腿曲张静脉破裂出血,。,7,.,2024/8/28,【常见护理诊断/问题】1、活动无耐力 与下肢静脉回流障碍有,【护理措施】,非手术治疗护理,/,术前护理,促进下肢静脉回流,改善活动能力,穿弹力袜或使用弹力绷带。,体位:采取良好坐姿,坐时双膝勿交叉过久,以免压迫腘窝,影响静脉回流;休息或卧床时抬高患肢,3040,,以利于静脉回流。,避免引起腹内压及静脉压增高的因素:保持大便通畅,避免长时间站立,肥胖者宜有计划地减轻体重。,8,.,2024/8/28,【护理措施】8.2023/9/5,非手术治疗护理,/,术前护理,预防或处理创面感染,观察患肢远端皮肤的温度、颜色,观察是否有肿胀、渗出,局部有无红、肿、压痛等感染现象。做好皮肤湿疹和溃疡的治疗及换药,促进创面愈合,预防创面继发感染,【护理措施】,9,.,2024/8/28,【护理措施】9.2023/9/5,正确使用弹力袜和弹力绷带,指导病人行走时穿弹力袜或使用弹力绷带,促进静脉回流。,穿弹力袜时,应平卧并抬高患肢,排空曲张静脉内的血液再穿,注意弹力袜的长短、压力及薄厚应符合病人的腿部情况。,弹力绷带自下而上包扎,不妨碍关节活动,并注意保持合适的松紧度,以能扪及足背动脉搏动及保持足部正常皮肤温度为宜。,10,.,2024/8/28,正确使用弹力袜和弹力绷带10.2023/9/5,术后护理,观察病情,观察病人有无伤口及皮下渗血、伤后感染等情况,发现异常及时通知医生。,早期活动,病人卧床期间指导其作足部伸屈和旋转运动;术后,24,小时可鼓励病人下地行走,促进下肢静脉血液回流,避免深静脉血栓形成。,保护患肢,活动时,避免外伤引起曲张静脉破裂出血。,11,.,2024/8/28,术后护理 观察病情 11.2023/9/5,健康教育,去除影响下肢静脉回流的因素,避免使用过紧的腰带和紧身衣物;避免肥胖;平时注意保持良好的坐姿,避免久站久坐;坐时避免双膝交叉过久。,休息与活动,休息时适当抬高患肢;指导病人进行适当的体育锻炼,增强血管壁弹性。,弹力治疗,非手术治疗病人坚持长期使用弹力袜或弹力绷带;手术治疗病人一般术后宜持续使用弹力袜或弹力绷带13个月,。,12,.,2024/8/28,健康教育 去除影响下肢静脉回流的因素 12.2023/9/,谢谢!,Thanks,13,.,2024/8/28,谢谢!Thanks13.2023/9/5,知识回顾,Knowledge Review,知识回顾Knowledge Review,15,.,8/28/2024,15.9/5/2023,
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