3例妊娠合并艾森曼格综合征患者的护理

目的 通过分析3例妊娠合并艾森曼格综合症患者的诊治经过,探讨妊娠合并艾森曼格综合症患者的护理对策,以期降低此类患者的病死率.方法 回顾性分析我院2003-2004年收治的3例妊娠合并艾森曼格综合症患者.结果 阴道分娩1例,剖宫产2例,1例产后产妇突然死亡,2例产后恢复良好.结论 妊娠合并艾森曼格综合征母儿预后很差,加强监护尽最大努力保护母儿的生命安全.全面、正确、有效地护理对策有助于使患者平稳度过围产期.     

3例妊娠合并艾森曼格综合征患者的护理

目的 通过分析3例妊娠合并艾森曼格综合症患者的诊治经过,探讨妊娠合并艾森曼格综合症患者的护理对策,以期降低此类患者的病死率.方法 回顾性分析我院2003-2004年收治的3例妊娠合并艾森曼格综合症患者.结果 阴道分娩1例,剖宫产2例,1例产后产妇突然死亡,2例产后恢复良好.结论 妊娠合并艾森曼格综合征母儿预后很差,加强监护尽最大努力保护母儿的生命安全.全面、正确、有效地护理对策有助于使患者平稳度过围产期.     

妊娠合并艾森曼格综合征患者的护理管理

目的 探讨妊娠合并艾森曼格综合征患者的护理管理方法.方法 充分利用各种有效的信息资源,多科室合作,提供循证护理和个体化护理措施.合理安排人力,重视患者的心理干预和院外指导.结果 两例患者经过科学的护理管理,在住院期间未出现严重并发症.结论 充分利用各种信息资源,提供针对性的预防措施,保障了患者的安全.     

妊娠合并艾森曼格综合征7例妊娠结局分析

目的探讨妊娠合并艾森曼格综合征对妊娠结局的影响。方法回顾性分析2000年1月到2009年12月滨州医学院附属医院收治的7例妊娠合并艾森曼格综合征患者的临床资料。结果 7例患者中,2例双胎,其中1例双胎入院时确诊死胎,患者均未定期孕检,临产后急诊转入,剖宫产后病情恶化,抢救无效死亡。5例患者定期孕检,孕晚期入院治疗,严密监测生命体征,血液动力学,血气分析的变化及胎儿发育情况,评估患者心功能并动态观察,择期剖宫产,产后恢复良好。7例早产儿,最低体重900 g,经新生儿科治疗,无围产儿死亡。结论妊娠合并艾森曼格综合征母儿预后很差,不宜妊娠,一旦妊娠应尽早行人工流产术。患者坚决要求继续妊娠者,应加强产期保健,尽早住院监护,加强与心内科、麻醉科、新生儿科合作,使患者平稳度过围生期,改善母儿预后。     

1例艾森曼格综合征病人剖宫产的手术护理

目的：加强对艾森曼格综合征病人剖宫产术中的护理，预防并发症的发生。方法：对艾森曼格综合征病人行剖宫产，术前做好充分的准备、予完善的监护方法、手术技巧和麻醉方法。结果：手术顺利完成。结论：合理、良好的手术护理是手术成功的重要保障。     

妊娠合并艾森曼格综合征危重患者术后重症监护室治疗分析

目的探讨妊娠合并艾森曼格综合征（Eisenmenger＇s syndrome,ES）危重患者术后重症监护室（ICU）的综合治疗方法。方法 2010年4～8月收治妊娠合并ES术后入ICU的3例危重患者,给予呼吸机辅助呼吸及强心、利尿、扩血管等对症治疗。结果 2例患者分别于术后1周内突然出现意识丧失、氧饱和度进行性降低而死亡,临床高度考虑为肺栓塞。另一例患者剖宫产术后入ICU,监护治疗4周平安出院。结论妊娠合并ES母儿的死亡风险极大,产后应入ICU监护治疗,雾化吸入伊洛前列素联合口服西地那非可有效降低肺动脉高压,从而减少右向左分流,降低患者病死率。     

妊娠合并艾森曼格综合征重症监护病房处理22例报告

在中国,妊娠合并心脏病是导致孕产妇死亡的第2位原因.回顾性分析本院2001年至2009年收治的艾森曼格综合征孕产妇临床资料,并针对如何提高患者在重症监护病房(ICU)期间的安全性进行讨论.     

6例艾森曼格综合征患者内科保守治疗的护理

6例艾森曼格综合征患者行内科保守治疗,其护理要点有:重视患者安全护理,重点关注患者有无猝死、晕厥的危险;加强用药护理,尤其是血管扩张药、靶向药物治疗的宣教;做好右心导管检查,术前介绍配合注意事项,术后注重观察伤口有无渗血及血肿情况;做好患者心理护理,引导患者逐步接受疾病现实,正确面对疾病,减轻焦虑;加强对患者的健康指导,注意避免增加发病风险事件的诱因(如妊娠、脱水、温度过高、缺氧、缺铁、感冒等);根据6 min步行试验结果,指导患者选择合理的运动方式,避免中-重度剧烈运动;完善对患者的院外随访,增强患者服药及随访依从性,了解病情进展。本组6例患者经治疗后病情稳定,安全出院,随访6个月未发生不良事件,未再入院。     

妊娠合并艾森曼格综合征剖官产术后患者的护理

艾森曼格综合征（Eisenmengersyndrome）指肺动脉高压性右向左分流综合征,可由房间隔缺损、室间隔缺损或大血管分流、动脉导管未闭等引起111。1897年由艾森曼格报道第1例,1958年由Wood重新命名。本病合并妊娠时,由于妊娠期、分娩期和产褥期血容量、血流动力学发生一系列变化,常发生严重心力衰竭、感染性心内膜炎及栓塞,预后很差,因此艾森曼格综合征属妊娠禁忌症。目前妊娠合并艾森曼格综合征的护理国内外报道较少见,我院2006年至2008年共收治妊娠合并艾森曼格综合征患者8例,现报道如下。     

艾森曼格综合征晚期妊娠孕产妇6例的护理

总结6例艾森曼格综合征晚期妊娠孕产妇的护理。护理重点为剖宫产术前做好护理评估和心理护理,密切观察病情,做好氧疗护理、用药护理,完善术前相关准备;剖宫产术后加强病情观察及监测,做好呼吸道护理、回乳护理、产褥期护理,并重视健康教育,以提高母婴救治成功率。6例新生儿均存活;5例产妇治疗好转出院,1例产妇放弃抢救治疗后死亡。     

Nursing Practice Strategies for Prenatal Care of Homeless Pregnant Women

Women who are homeless are less likely to receive preconception care or prenatal care in the first trimester, and they tend to have fewer prenatal visits overall than their housed counterparts. Homelessness during pregnancy can increase the risk for many maternal, fetal, and neonatal complications. Barriers to proper prenatal care can be categorized as logistical, psychosocial, intellectual, and attitudinal. Although all women face potential barriers to optimal care, women who are homeless are particularly vulnerable and experience these barriers to a greater degree. Nursing strategies for prenatal care of homeless pregnant women include therapeutic communication, focused assessment, and upstream interdisciplinary approaches.     

影响输卵管妊娠就诊的相关因素及护理对策

目的：探讨影响输卵管妊娠就诊的相关因素及护理对策。方法：对167例输卵管妊娠病例相关因素进行回顾性分析。结果：小同的就诊方式对治疗方法的选择有明显的区别。结论：早就诊,早治疗可以降低手术率,减少并发症发生。     

Patient-Centered Strategies to Improve Radiographic Practice for Patients with Down Syndrome: A Systematic Review

BackgroundDown syndrome is a common human genetic disorder caused by trisomy of chromosome 21. Individuals with Down syndrome can present with a range of health issues during their lives that may require imaging for diagnosis. Radiographers, therefore, play a significant role in the management and communication of Down syndrome patients' health.PurposeThis review identified patient-centered strategies that radiographers should use to provide quality imaging services for Down syndrome patients, who may have limited verbal ability and behavioral issues.MethodA systematic review using the established PRISMA guidelines was undertaken of current literature obtained through the Ovid and Scopus databases. A total of 189 articles were found, of which 41 were categorized and analyzed in detail.FindingsA high level of care for Down syndrome patients will require longer than usual procedures, and the patients will not respond well to being rushed or ignored. Down syndrome patients have difficulty verbalizing, yet they understand more than is often thought. Individuals may require increased imaging time to give them time to respond, especially to pain. Patients are at risk of injury with AAI or other pathologies, and caution should be taken with flexion and extension spine x-rays. Radiographs may reveal undisclosed physical abuse.ConclusionSpecific strategies with verbal and nonverbal communication help to facilitate communication, reduce anxiety and fear, and improve compliance with Down syndrome patients. Patients may require an increased level of care; increased imaging time; and allowing support people to be present during the examination process.     

3例不动纤毛综合征患者行鼻内镜手术的呼吸道护理

报道3例不动纤毛综合征患者行鼻内镜手术的呼吸道护理.主要护理措施包括:术前心理护理,积极控制呼吸道感染,确保麻醉安全;术后加强气道湿化,防止误吸及窒息的发生,做好控制感染及控制高热的护理.认为针对患者反复的呼吸道感染以及疾病特征,给予术前、术后呼吸道护理是预防肺部并发症,提高手术成功率的关键.3例患者平稳度过围术期,病情好转出院.     

Monitored anesthesia care for craniotomy in a patient with Eisenmenger syndrome: A case report

BACKGROUNDEisenmenger syndrome (ES) is an uncorrected congenital cardiac defect with a left-to-right shunt, leading to pulmonary arterial hypertension. Patients with ES are susceptible to hemodynamic alterations during noncardiac surgery with general anesthesia, which increases perioperative morbidity and mortality. Monitored anesthesia care (MAC) is often used during minor procedures in patients with cardiac disease. However, few reports on MAC in patients with ES exist.CASE SUMMARYA 49-year-old man was admitted for a severe headache lasting 30 d. He had been diagnosed with a large perimembranous ventricular septal defect (VSD) with bidirectional shunt flow and pulmonary arterial hypertension 10 years ago. A round mass in the right frontal lobe was revealed by Magnetic resonance imaging. Stereotactic aspiration using a neuronavigation system was performed under MAC. The patient was stayed in the hospital for 5 d, and discharged without complications.CONCLUSIONMAC may be effective for craniotomy in patients with ES.     

三尖瓣下移畸形合并预激综合征患者的术后加强护理

目的 报告三尖瓣下移畸形（Ebstein畸形）合并预激综合征（W－P－W）患手术治疗后的护理经验。方法 对13例Ebstein畸形合并预激综合征患进行外科治疗，手术切割房室附加旁道并行三尖瓣成形或置换术。术后加强护理：（1）心律失常的监护；（2）低心排综合征的防治；（3）呼吸功能的维护；（4）抗凝治疗的观察。结果 全组13例患未发生术后并发症，均痊愈出院。术后随访9个月－7年，无晚期死亡，无预激综合征笔发，心功能I级11例，Ⅱ级2例。结论 手术治疗Ebstein畸形合并预激综合征，可同时纠正三尖瓣功能障碍和预激综合征，获得良好的效果。对此类患术后施行加强护理，可提高手术成功和患生存质量。     

Eisenmenger syndrome and other types of pulmonary arterial hypertension related to adult congenital heart disease

Introduction: Eisenmenger syndrome (ES) is the most advanced form of pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD). It is characterised by a severe rise in pulmonary vascular resistance resulting in shunt reversal and cyanosis.

Areas covered: In this paper, an overview of ES and other types of PAH related to CHD (PAH-CHD) in adults is provided. The modern management of PAH-CHD in tertiary centers is described, with an emphasis on co-morbidities and complications.

Expert opinion: PAH-CHD describes a wide spectrum of conditions, of which ES is the archetype. The size and location of the shunt, the degree of adaptation of the right ventricle to the increased afterload and other compensatory mechanisms, such as secondary erythrocytosis, define the clinical presentation and natural history of these patients. PAH therapies have improved the quality of life and outcome of many patients with PAH-CHD, but expert multidisciplinary management remains essential in optimising the care of this rare and complex group of patients.