24例经导管主动脉瓣植入术中并发症的观察及护理

共24例主动脉瓣重度狭窄的患者,行经导管主动脉瓣植入术均获成功。术中发生并发症4例,1例室性颤动,2例血管并发症,1例腹膜后血肿,3例Ⅲ度房室传导阻滞,经及时处置均手术成功。因该组患者高龄、病情重、手术风险高,需备齐术中所需物品、药品;术中做好手术配合,操作规范细致;密切观察心电图、血压、血氧饱和度的异常改变,以及穿刺点周围出血情况;设1名专门护士,重点做好临时起搏器及除颤仪的管理,一旦发生并发症,及时配合医生处理。认为护士应在术中熟练掌握监护仪、除颤仪、临时起搏器等仪器操作,熟悉手术进程,熟知术者每一操作配合要领及潜在的风险,及时发现并发症、有效配合抢救。

Complications in Transcatheter Aortic Valve Implantation and Its Nursing：A 24-case Study

This paper introduced the nursing experience of complications in transcatheter aortic valve implantation （TAVI）. There were 24 patients undergoing TAVI successfully in the study. During the operation, four kinds of complications occurred including one case of ventricular fibrillation, two of vascular complications and one of third degree atrioventricular block. After timely treatment, all patients underwent the operation smoothly. Preoperative preparation of all the materials and medication needed played a critical role in the operation. During the operation, cooperation and close observation of electrocardiography, blood pressure, blood oxygen saturation for its potential change, bleeding in puncture points were of great significance. There should be one nurse that was particularly responsible for the management of pacemaker and defibrillator. In the whole operation, nurses were supposed to be familiar with the operation of monitors, pacemaker and defibrillator, the process of the operation, key points of cooperation and potential risks. Once complication occurred, effective cooperation played a key role in the success of the operation.