19例经导管主动脉瓣植入术患者的护理及治疗效果评价

目的：总结经导管主动脉瓣植入术(TAVI)治疗重度主动脉瓣狭窄的术前术后护理经验，并对治疗效果进行评价。方法：选取2016年3月—2020年4月19例行TAVI术患者为研究对象，术前充分了解病情，完善相关检查，给予饮食、活动及心理护理，术后观察病情变化并对症处理。分别在术前和术后1,3,6个月评估心功能分级(NYHA),并监测主动脉瓣口面积、左心射血分数(LVEF)及血清N端脑钠肽前体(NT-ProBNP)等指标，评价治疗效果。结果：19例患者均康复出院，随访半年治疗效果良好，生活质量改善。术前NYHA分级Ⅲ级10例、Ⅳ级9例，术后6个月NYHA分级Ⅰ级15例、Ⅱ级4例；术后主动脉瓣口面积、LVEF、血清NT-ProBNP与术前比较，差异均有统计学意义(P<0.05)。结论：TAVI操作难度大、并发症多，术前应全面评估，预见性发现问题，根据患者出现的情况行针对性处理，并于术后对患者实施全面持续的护理，可提高治疗效果。

Nursing and therapeutic effect evaluation of 19 patients with transcatheter aortic valve implantation

Objective:To summarize the preoperative and postoperative nursing experience of transcranial aortic valve replacement(TAVI)in the treatment of severe aortic stenosis,and evaluate the therapeutic effect.Methods:All 19 patients undergoing TAVI surgery in the First Affiliated Hospital of Bengbu Medical College from March 2016 to April 2020 were selected as the study subjects.Patients were fully understood about their condition before operation,and relevant examinations were improved.Diet,activities and psychological nursing were given to them.Cardiac function grading(NYHA)was evaluated before and 1,3,and 6 months after surgery,and aortic valve orifice area,left ventricular ejection fraction(LVEF),serum NT-proBNP and other indicators were monitored to evaluate the therapeutic effect.Results:All 19 cases were recovered from patients.Followed up for 6 months treatment effect is good,the quality of life improved,preoperative NYHAⅢlevel 10 cases,Ⅳlevel 9 cases,6 months afterⅠlevel 15 cases,Ⅱlevel 4 cases.The aortic valve area,LVEF and serum NT-ProBNP after operation were compared with those before operation,and the differences were statistically significant(P<0.05).Conclusion:TAVI is a difficult operation with many complications.Comprehensive preoperative routine assessment,predictive detection of problems,targeted treatment according to the patient's situation,and comprehensive and continuous postoperative care can improve the treatment effect of patients.