Amplatzer封堵器治疗膜部或膜周部室间隔缺损围手术期护理

目的:了解应用Amplatzer非对称形封堵器介入治疗膜部或膜周部室间隔缺损(VSD),探讨护理及预防并发症发生的方法.方法:对45例接受介入治疗的膜部或膜周部室间隔缺损患者进行回顾性分析,并针对可能发生的并发症实施相应的护理对策.结果:45例患者共接受46次手术.1例3岁患儿经导管检查证实为双孔VSD,因检查时间过长和造影剂已用足量,改日手术成功;1例患者术后4小时发生溶血,保守治疗4天无效,改外科手术治疗.1例患者术后一个月发生偏头痛,经治疗痊愈.结论:Amplatzer室间隔封堵器治疗膜部或膜周部室间隔缺损是一种简单、安全、有效的介入治疗方法,为室间隔缺损的治疗开辟了一条新的途径,可取代部分病例的外科治疗.通过准确的术前决策,充分的术前准备,娴熟的操作技术以及积极的围手术期护理,可以提高室间隔缺损封堵术的成功率,避免并发症发生.

The Perioperational Nursing of Interventional Therapy for Membranous or Perimembranous Ventricular Septal Defect with Amplatzer Occluder

Objective: To study the effect of interventional therapy for membranous or perimembranous ventricular septal defect (VSD) witheccentric Amplatzeroccluder, and to discuss the wayof nursing and preventing complications. Methods: Analyzing retrospectively 45 patients with membranous or perimembranous VSD accepted interventional therapy and giving them different nursing care according to their respective complications. Results: 46 procedures were performed on 45 patients. Procedure was failed in 1 patient with 2 holes in ventricular septal in the first time but performed successfully in another day. Hemolysis occurred in one patient and could not control in medicine, then treated by surgery. Migraine occurred in one case one month after operation, and fully recovered after treatment. Conctosion: Transcatheter closure of membranous or perimembranous VSD with Amplatzer membranous VSD occluder is simple, safe and effective, which develop a new therapeutic way for VSD and could substitute surgery during part of cases. In order to rise the successful rate and reduce complications, accurate decision, sufficient preparation before therapy, gracious technique and active custodial during and after operation are needed.