风湿性心瓣膜病合并心房颤动术中护理风险分析及护理

目的探讨风湿性心瓣膜病合并心房颤动(atrial fibrillation,AF)心瓣膜置换同期射频消融术中护理风险,并总结护理要点。方法对119例风湿性心瓣膜病合并AF实施心瓣膜置换同期射频消融手术中存在的护理风险(包括水电解质和酸碱平衡紊乱、心律失常、低体温、皮肤压疮、有效循环血容量锐减、感染等风险)进行分析,并采取相应护理措施。结果本组术中11例患者主动脉开放后出现心室颤动,31例患者体外循环复温后出现低体温,1例患者主动脉开放后发现左心房顶部出血,经处理后患者手术均顺利完成;手术时间178~310min,平均(245.32±34.40)min。结论心瓣膜置换同期射频消融术治疗风湿性心瓣膜病合并AF可取得良好的治疗效果,护士做好详尽的护理风险分析,并采取有效的应对措施,是手术顺利完成的重要因素。

Nursing risks in patients undergoing radio-frequency ablation during cardiac valve replacement

Objective To investigate the nursing risks in the patients undergoing radio-frequency ablation surgery during cardiac valve replacement.Methods The nursing risks in 110 patients undergoing radio-frequency ablation surgery during cardiac valve replacement were summarized to include disorder of water electrolyte and acid-base balance, arrhythmia,hypothermia,skin ulcer,reduction of effective circulating blood volume,infection and so on, so as to carry out the corresponding nursing measures. Results Ventricular fibrillation occurred in 11 patients,hypothermia after rewarming on cardiopulmonary bypass in 31 patients,left atrial bleeding after aortic de-clamping in 1 patient.All the complications were successfully controlled by corresponding management. The operation time ranged from 178 mins to 310 mins and average time was（245.32±34.40）mins.Conclusion The full-scale assessments and effective nursing interventions are the key points to improve the efficiency and success of cardiac valve replacement combined with radio-frequency ablation.