介入术后急性心脏压塞的护理策略

目的 探讨经桡动脉行冠状动脉造影介入治疗患者并发心脏压塞的早期征象,诊治流程及护理策略,从而改善预后、降低病死率.方法 回顾性分析2011年1月至2013年10月年北京安贞医院抢救中心采用经桡动脉行冠状动脉造影介入治疗5 595例患者临床资料.结果 心脏压塞的早期征象为胸痛、极度烦躁、面色苍白、大汗,呼吸困难、血压下降,特别是收缩压下降、心率增快,早期诊断手段为超声心动图;护理工作应认真观察患者生命体征,及时上报,做好心包穿刺护理工作,避免心包穿刺并发症发生.本研究结果显示在5 595例介入检查患者中8例发生心脏压塞,发病率为0.14%,经及时发现积极抢救,救治成功率为100%.结论 早期发现经桡动脉行冠状动脉造影介入治疗后心脏压塞,正确诊断,积极护理,可以改善预后、降低病死率.

Nursing strategy of acute pericardial tamponade after interventional therapy

Objective To explore the early signs,treatment process and the nursing strategies of pericardial tamponade after transradial coronary angiography interventional therapy, and improve the prognosis and decrease the mortality. Methods Retrospective analysis of clinical data of 5 595 patients by transradial coronary angiography interventional treatment in Beijing Anzhen Hospital emergency center from January 2011 to October 2013. Results The patients with pericardial tamponade show chest pain, extreme irritability, pale, sweating, difficulty in breathing, blood pressure decreased, especially systolic blood pressure decreased, increased heart rate. Early diagnosis method is ultrasonic cardiogram; nurse should carefully observe the vital signs of patients, timely report and maintenance of pericardial puncture, in order to avoid the occurrence of pericardial puncture complications. The results showed that 8 patients with cardiac tamponade in the 5 595 cases which interventional therapy , the incidence rate was 0.14%.The success rate of treatment was 100% after early detection and treatment timely. Conclusion Early detection of pericardial tamponade, the correct diagnosis and active nursing can improve the prognosis and decrease the mortality.