Ⅲ型主动脉夹层围手术期应用硝普钠致精神异常的护理

【】　目的　Ⅲ型主动脉夹层非体外循环腔内支架隔离术在围手术期应用硝普钠控制性降压易导致精神失常，总结相关护理经验。　方法　2009年7月-2010年2月确诊Ⅲ型主动脉夹层动脉瘤患者36例，围手术期应用硝普钠控制性降压，均采用非体外循环主动脉腔内隔离术治疗，排除手术、麻醉等因素所致脑损伤而产生的术后精神异常。　结果　有5例出现不同程度精神失常，经加用口服降压药，减少硝普钠泵入剂量，缩短硝普钠使用时间，经过精心治疗及护理，患者精神异常症状逐渐减轻直至消失。　结论　长期、大剂量应用硝普钠易导致精神失常，需加强护理，及时发现，及时处理。【Abstract】　Objective　Tosummarizethenursingexperiencesformentaldisorderscausedbysodiumnitroprussideusedtocurehypertensioninpatientsreceivingoff-pumpinterventionsurgeryforDeBackeyⅢaorticdissection.　Methods　FromJuly2009toFebruary2010,36patientswerediagnosedtohaveDeBackeyⅢaorticdissectioninourdepartment.Allpatientsreceivedoff-pumpinterventionsurgery.Weusedsodiumnitroprussidetocontrolhypertensionduringtheoperation.Mentaldisorderscausedbybraindamagefromsurgery,anesthesiaandotherfactorswereruledout.　Results　Fivepatientssufferedfrompsychiatricdisorders.Oralantihypertensivedrugswereused,andwereducedthedoseandshortenedthetimeofusingsodiumnitroprusside.Afterintensivetreatmentandcare,thesymptomsofmentaldisordersalleviatedanddisappeared.　Conclusion　Long-termandlargedoseofsodiumnitroprussidecaneasilyleadtomentaldisorders,whichrequiresintensivecare,timelydetectionandtreatment.