经导管三尖瓣缘对缘修复术患者的手术护理
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女,本科,主管护师

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浙江省科技计划项目(2023C03087);浙江省教育厅一般科研项目(自然科学类)(Y202353856)


Intraoperative care of patients undergoing transcatheter edge-to-edge valve repair for tricuspid regurgitation
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    摘要:

    总结25例经导管三尖瓣缘对缘修复患者的手术护理经验。护理重点包括术前对高风险患者做好差异化应急准备,完善三尖瓣夹合器和手术仪器准备;术中针对三尖瓣反流疾病特征安置舒适体位,调试操作系统避免血栓及空气栓塞,警惕患者肝素化过程中的出血,积极预防术中恶性心律失常,实施目标导向性的血糖护理干预;术后转运避免夹合器脱落等。患者手术顺利,术后即刻反流由重度及以上下降至轻度13例,下降至中度10例,2例反流等级分别从5级和4级下降为3级;术后3~7 d出院。术后随访6个月,25例患者反流等级均在3级及以下,心功能和生活质量均有显著改善。

    Abstract:

    A total of 25 patients underwent transcatheter edge-to-edge valve repair for tricuspid regurgitation.The experiences of caring for these patients during the operation were summarized, including making preparedness plans for emergency situations for high-risk patients; preparing surgical instruments and clips for valve repair; placing patient at comfortable position based on the characteristics of tricuspid regurgitation; adjusting the operating system to avoid thrombosis and air embolism; monitoring blee-ding complications during heparinization; preventing malignant arrhythmias; implementing goal-directed glycemic control; and preventing clamp dislodgement.Immediately after the operation, the regurgitation grade was decreased, from severe or very severe (grade≥3), to mild (grade 1) in 13 patients, to moderate (grade 2) in 10 patients, and to grade 3 in 2 patients.All patients were discharged in 3 to 7 days after the surgery, and followed-up for 6months.Regurgitation grade was≤3, cardiac function and quality of life were significantly improved.

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王雅琳,陈丽莉,钱吉利,孙新星.经导管三尖瓣缘对缘修复术患者的手术护理[J].护理学杂志,2024,39(17):55-57+60

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  • 收稿日期:2024-04-22
  • 最后修改日期:2024-06-18
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  • 在线发布日期: 2024-10-15