摘要
目的总结主动脉瓣重度狭窄老年患者行经心尖介入主动脉瓣植入术(TA-TAVI)的手术护理经验,为相关护理提供借鉴。方法对12例主动脉瓣重度狭窄老年患者在DSA杂交手术室于全麻下行TA-TAVI。术前充分了解患者情况、手术流程及配合要点,做好访视、物品及器械准备;术中密切配合手术,做好应对突发情况准备;术后及时回访。结果 12例均成功完成TA-TAVI,手术时间2~5h,术后住院4~14d好转出院;随访1~7个月,1例因出现Ⅲ度房室传导阻滞植入永久起搏器,余11例一般情况好,维持无临床症状状态。结论 TA-TAVI对于高风险的严重主动脉瓣狭窄老年患者相对安全有效;护理人员熟悉老年患者病情及手术步骤,做好充分的术前准备及熟练术中配合是保证手术顺利实施的关键。
Objective To summarize the nursing experience for elder patients with severe aortic stenosis treated with transapical transcatheter aortic valve implantation（TA-TAVI）,and to provide reference for operations of the same kind.Methods A total of 12 patients with severe aortic stenosis received TA-TAVI under general anesthesia in the hybrid operating room fully equipped with digital subtraction angiography（DSA）system.Before the surgery,nurses read through patients′charts,fully studied the surgery flow and cooperation key points,and made meticulous preoperative preparations,such as paying preoperative visits,giving health education to patients,and readying the equipment and devices for the surgery.During the operation,nurses made close observation,and readied themselves for emergencies.After operation,they followed-up the patients timely.Results The 12 patients successfully completed TA-TAVI,which lasted 2 to 5 h.The patients were discharged from hospital 4 to 14 days post-operatively with better conditions.They were followed-up 1 to 7 months,and only one case was found to develop third degree atrioventricular block and later received implantation of permanent pace maker.The rest 11 cases were in good condition without clinical symptoms.Conclusion TA-TAVI is relatively safe for high risk elder patients with severe aortic stenosis.Nurses should be familiar with elder patients′conditions and the surgical process,make meticulous preoperative preparations,and render skillful cooperation during the operation,which will smooth the operation.
作者
沈剑辉
高兴莲
鄢利芳
甘琴
梅竹
何慧
Shen Jianhui;Gao Xinglian;Yan Lifang;Gan Qin;Mei Zhu;He Hui(Operating Room,Union Hospital Affiliated to Tongji Medical College,Huazhong University Science and Technology,Wuhan 430022,china)
出处
《护理学杂志》
CSCD
北大核心
2018年第18期46-48,共3页
Journal of Nursing Science
关键词
老年患者
主动脉瓣狭窄
经心尖入路主动脉瓣植入术
手术中护理
elderly patients
aortic stenosis
transapical transcatheter aortic wdve implanlation
intra-operative nursing care
