Title Zdravstvena njega bolesnika s disekcijom aorte
Title (english) Nursing Care of Patients with Aortic Dissection
Author Dijana Bogdan
Mentor Dragica Kustura (mentor)
Committee member Slavica Kozina (predsjednik povjerenstva)
Committee member Deana Švaljug (član povjerenstva)
Committee member Dragica Kustura (član povjerenstva)
Granter University of Split (University Department of Health Studies) Split
Defense date and country 2014-09-09, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences
Abstract Akutna disekcija aorte je ozbiljno stanje koje traži neodgodivo medicinsko i kirurško zbrinjavanje. Disekcija aorte nastaje zbog uzdužnog raslojavanja intime aorte. Uslijed odvajanja središnjeg dijela aorte ( medija ) nastaju dva lumena. U pravom lumenu se registrira protok krvi dok je u lažnom lumenu protok mali ili ga uopće nema. Lažni lumen je obično za 50% većeg lumena od pravog. Rizici za akutnu disekciju aorte su različiti. U 80 % slučajeva ovog poremećaja radi se o bolesnicima sa hipertenzijom. Jednako važni faktori rizika su i ateroskleroza aorte, bikuspidna valvula aorte, koarktacija aorte, različita oboljenja vezivnog tkiva ( Marfanov sindrom ) kao i cistična nekroza medije aorte. Simptomi akutne disekcije aorte su: Naglo nastala bol u grudima sa širenjem u vrat, leđa, obije ruke ili noge u zavisnosti od lokalizacije disekcije. Nesvjestica i opća slabost organizma nastaju kao posljedica začepljenja arterija koje izlaze iz aorte uslijed disekcije. Akutni infarkt miokarda je jedna od mogućih, pratećih komplikacija.
Dijagnosticiranje akutne disekcije aorte vrši se uz pomoć anamneze, pregleda, EKG, rentgena pluća i srca, magnetne rezonance, koronarne tomografije ili aortografije. Laboratorijski parametri koji pomažu u dijagnostici su D-dimer i Troponin T ili I.
Postoje dvije podjele prema lokalizaciji disekcije aorte: Prema Stanfordskoj klasifikaciji, aortna disekcija se, u odnosu na mjesto početnog rascjepa intime dijeli na tip A (disekcija zahvaća descedentnu aortu) i tip B (disekcija ne zahvaća ascendentnu aortu). Stanford A zahtijeva kiruršku operaciju.
Nakon operacije pacijent se smješta u Kardiokirurški Jil gdje se trajno monitorira i prati 24h/dan od strane posebno educiranih medicinskih sestara i liječnika –kardioanesteziologa. U Kardiokirurškom Jilu se zadržava dok je vitalno ugrožen, zatim se premješta na u Jinj – jedinicu intenzivne njega na odjel kardiokirurgije.
Abstract (english) Acute aortic dissection is a serious condition that seeks immediate medical and surgical care. Aortic dissection occurs due to longitudinal stratification aortic intima. Due to the separation of the central part of the aorta (the media) are formed two lumens. In the true lumen registers blood flow while in the false lumen flow of small or absent. False lumen is typically 50% larger than the true lumen. Risks for acute aortic dissection are different. In 80% cases of this disorder are the patients with hypertension. Equally important are the risk factors and atherosclerosis of the aorta, bicuspid aortic valve, coarctation of the aorta, various diseases of the connective tissue (Marfan syndrome) and cystic medial necrosis of the aorta media. Symptoms of acute aortic dissection includes: abrupt onset of chest pain that spreads to the neck, back, both hands or feet, depending on the localization of dissection. Fainting and general weakness of the body are the result of clogged arteries that come out due to aortic dissection. Acute myocardial infarction is one of the possible, related complications.
Diagnosis of acute aortic dissection is carried out with the help of the history, examination, ECG, X-ray of lungs and heart, magnetic resonance imaging, coronary tomography or aortography. Laboratory parameters that helps in the diagnosis are D-dimer and troponin T or I. There are two divisions for localization of aortic dissection: according Stanfordskoj classification, aortic dissection, compared to the initial location of the split intimate divided into type A (dissection affects descedentnu aorta) and type B (dissection does not affect the ascending aorta). Stanford A requires a surgical operation. After surgery, the patient is placed into the intensive care – cardio department where is permanently monitored for 24 hours / day and observed by specially trained nurses and doctors-cardioanestesiologist. In ICD- cardio is retained while his life is in vital danger, then he moves on to the intensive care unit of cardiac surgery department.
Keywords
akutna disekcija aorte
hipertenzija
kardiokirurgija (ključne riječi unio urednik)
Keywords (english)
acute aortic dissection
hypertension
cardiac surgery (ključne riječi unio urednik)
Language croatian
URN:NBN urn:nbn:hr:176:415669
Study programme Title: Nursing (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-06-25 12:51:03