目的 通过对22例采用联合入路下导丝交汇技术治疗锁骨下动脉慢性闭塞患者的围手术期护理观察,总结联合入路下导丝交汇技术治疗锁骨下动脉慢性闭塞的护理要点。方法 所有锁骨下动脉慢性闭塞患者（n=22）均采用股动脉顺行入路和患肢肱动脉逆行入路,使用导丝交汇技术开通闭塞血管,在围手术期给于全面细致的护理,包括术前检查及护理准备、心理护理及健康教育、术中护理配合、术后并发症护理与观察。结果 22例患者在科学、系统、精心的治疗护理下,手术全部顺利完成,成功开通20例,成功率90.9%,未发生严重并发症。20例开通病例3个月随访未发生再狭窄,再狭窄率0%,1年随访再狭窄2例,行球囊扩张后缓解,再狭窄率10%。结论 应用联合入路下导丝交汇介入技术治疗锁骨下动脉慢性闭塞的手术成功率高,是一种安全有效的治疗手段,围手术期加强心理护理、生命体征监测、并发症的预防及护理,是确保手术成功的有力保障。并发症的预防及护理,是确保手术成功及防治相关并发症的有力保障。

Objective To summarize the nursing key points for patients with chronic subclavian artery occlusion receiving combined approach and guidewire intersection technology through perioperative nursing observation of 22 patients. Methods Patients with chronic subclavian artery occlusion （n=22） were treated with anterograde femoral artery approach and retrograde brachial artery approach. The occluded vessels were opened by guidewire intersection technology. All patients received comprehensive and careful nursing during the perioperative period, including preoperative examination and nursing preparation, psychological nursing and health education, intraoperative nursing cooperation, postoperative complication care and observation. Results All patients were successfully treated with scientific, systematic, and meticulous nursing. Twenty occluded cases were successfully opened, and the success rate was 90.9%. No serious complications occurred. Among the 20 patients followed up, there was no restenosis in 3 months （0%） and 2 cases in 1 year（0%）. Conclusion The application of combined approach and guidewire intersection technology in the treatment of chronic subclavian artery occlusion has a high success rate, and is a safe and effective treatment. Perioperative psychological nursing, monitoring of vital signs,prevention and nursing of complications are a powerful guarantee for a successful operation.