摘要
总结25例经导管三尖瓣缘对缘修复患者的手术护理经验。护理重点包括术前对高风险患者做好差异化应急准备,完善三尖瓣夹合器和手术仪器准备;术中针对三尖瓣反流疾病特征安置舒适体位,调试操作系统避免血栓及空气栓塞,警惕患者肝素化过程中的出血,积极预防术中恶性心律失常,实施目标导向性的血糖护理干预;术后转运避免夹合器脱落等。患者手术顺利,术后即刻反流由重度及以上下降至轻度13例,下降至中度10例,2例反流等级分别从5级和4级下降为3级;术后3~7 d出院。术后随访6个月,25例患者反流等级均在3级及以下,心功能和生活质量均有显著改善。
A total of 25 patients underwent transcatheter edge-to-edge valve repair for tricuspid regurgitation.The experiences of caring for these patients during the operation were summarized,including making preparedness plans for emergency situations for high-risk patients;preparing surgical instruments and clips for valve repair;placing patient at comfortable position based on the characteristics of tricuspid regurgitation;adjusting the operating system to avoid thrombosis and air embolism;monitoring blee-ding complications during heparinization;preventing malignant arrhythmias;implementing goal-directed glycemic control;and preventing clamp dislodgement.Immediately after the operation,the regurgitation grade was decreased,from severe or very severe(grade≥3),to mild(grade 1)in 13 patients,to moderate(grade 2)in 10 patients,and to grade 3 in 2 patients.All patients were discharged in 3 to 7 days after the surgery,and followed-up for 6months.Regurgitation grade was≤3,cardiac function and quality of life were significantly improved.
作者
王雅琳
陈丽莉
钱吉利
孙新星
Wang Yalin;Chen Lili;Qian Jili;Sun Xinxing(Operating Room,The First Affi-liated Hospital of Zhejiang University School of Medicine,Hangzhou 311200,China)
出处
《护理学杂志》
CSCD
北大核心
2024年第17期55-57,60,共4页
Journal of Nursing Science
基金
浙江省科技计划项目(2023C03087)
浙江省教育厅一般科研项目(自然科学类)(Y202353856)。
关键词
三尖瓣反流
经导管三尖瓣缘对缘修复术
介入手术
应急准备
血糖管理
血栓
空气栓塞
手术室护理
tricuspid regurgitation
transcatheter tricuspid edge-to-edge valve repair
interventional surgery
emergency preparedness
glycemic control
thrombosis
air embolism
intraoperative nursing care
