瓣膜置换同期行改良CoxⅢ迷宫手术治疗风湿性心脏瓣膜病伴房颤患者的护理

目的总结瓣膜置换同期行改良CoxⅢ迷宫手术治疗风湿性心脏瓣膜病伴房颇的护理效果和经验。方法回顾分析2006年4月-2008年7月收治的58例瓣膜置换同期行CoxⅢ迷宫手术的风湿性心脏瓣膜病伴房颤患者的护理措施。结果本组病例中围手术期因肾功能衰竭死亡1例，低心排死亡1例，感染性心内膜炎死亡1例，死亡率5．2％，其余均康复出院。在术后住院期间及术后短期随访中存活患者均为窦性心律。在完成术后6个月随访的43例患者中，有3例（7．0％）出现房颤心律，其余均保持窦性心律。结论对于瓣膜置换同期行迷宫手术的患者，护理上要注意术前的心理护理及呼吸道准备，术后加强对患者心功能的监护，注意抗凝治疗的护理。

Nursing,of patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation

Objective To summarize the effect and experience of nursing of patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation. Methods A retrospective analysis was carried out in the nursing of 58 patients with rheumatic valvular heart disease with atrial fibrillation treated with Cox Ⅲ labyrinth and simultaneous valve replacement operation in our hospital from April 2006 to July 2008. Results One patient died of perioperative renal failure,one died of low cardiac output,one died of infectious endocarditis.The mortality rate reached 5.2% .Other patients were discharged from hospital after completely cured.The survived patients maintained sinus rate during hospitalization days after operation and short-term follow-up after being discharged.Among 43 patients who completed follow-up of 6 months after operation,3 patients （7.0%） demonstrated atrial fibrillation,while others still kept sinus rate. Conclusions Attention should be paid to psychological nursing,respiratory tract preparation,cardiac function monitoring and nursing of anticoagulation treatment for patients treated with CoxⅢ labyrinth and simultaneous valve replacement operation.