一例B超引导下经皮射频消融治疗肾上腺皮质腺瘤库欣综合征合并类固醇糖尿病患者的护理
Nursing of radiofrequency ablation for adrenocortical adenoma with Cushing's syndrome combined steroid-induced diabetes mellitus: one case report
摘要目的:总结1例B超引导下经皮射频消融治疗肾上腺皮质腺瘤库欣综合征合并类固醇糖尿病的护理经验。方法:术前采用胰岛素泵精准控糖;关注患者情绪变化,适时给予心理疏导;术中密切监测血压、皮质醇水平和生化指标的变化,防治肾上腺危象等并发症;术后进行全程营养管理,减少血糖波动,重视氢化可的松不良反应的自我观察与宣教,针对性做好出院指导。结果:术中无严重并发症出现,经过20 d精心治疗和护理,患者血糖控制平稳,库欣综合征达到临床缓解,术后短期经过激素补充治疗,病情明显好转出院。结论:B超引导下经皮射频消融治疗肾上腺肿瘤库欣综合征合并类固醇糖尿病安全可靠,充分术前准备,术中、术后密切监测,是有效减少术后并发症,保证手术成功的关键。
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abstractsObjective:To summarize experience of nursing in radiofrequency ablation (RFA) for adrenocortical adenoma with Cushing′s syndrome combined steroid-induced diabetes mellitus.Methods:The key of preoperative nursing was precise glucose control by using insulin pump. Focus on patients psychological intervention. It was important for closely monitor the change of blood pressure, cortisol levels and biochemical index to prevent acute complications such as adrenal crisis during RFA. Pay attention to postoperative nutrition management for reduce blood glucose fluctuation and adverse reactions of hydrocortisone at postoperative.Results:No severe complications occurred during this procedure. After twenty-day nursing and treatment, the patient′s blood glucose control was stable, and the symptoms related to Cushing′s syndrome gradually disappeared.Conclusion:The ultrasound guided radiofrequency ablation in adrenocortical adenoma with Cushing′s syndrome combined with steroid-induced diabetes mellitus was a feasible, safe, and minimally invasive treatment. The key to effectively reduce postoperative complications and ensure the success of the operation. Are adequate preoperative preparation and strict monitor.
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