周静, 徐静. 重度心力衰竭患者心脏再同步治疗的围术期护理[J]. 蚌埠医学院学报, 2015, 40(1): 118-120. DOI: 10.13898/j.cnki.issn.1000-2200.2015.01.039
    引用本文: 周静, 徐静. 重度心力衰竭患者心脏再同步治疗的围术期护理[J]. 蚌埠医学院学报, 2015, 40(1): 118-120. DOI: 10.13898/j.cnki.issn.1000-2200.2015.01.039
    ZHOU Jing, XU Jing. Perioperative care of severe heart failure patients treated with cardiac resynchronization therapy[J]. Journal of Bengbu Medical College, 2015, 40(1): 118-120. DOI: 10.13898/j.cnki.issn.1000-2200.2015.01.039
    Citation: ZHOU Jing, XU Jing. Perioperative care of severe heart failure patients treated with cardiac resynchronization therapy[J]. Journal of Bengbu Medical College, 2015, 40(1): 118-120. DOI: 10.13898/j.cnki.issn.1000-2200.2015.01.039

    重度心力衰竭患者心脏再同步治疗的围术期护理

    Perioperative care of severe heart failure patients treated with cardiac resynchronization therapy

    • 摘要: 目的:总结重度慢性心力衰竭患者进行心脏再同步化(CRT)或安装三腔起搏器加心律转复除颤器治疗(CRT-D)的围术期护理体会.方法:对8例慢性心力衰竭患者CRT或CRT-D治疗行术前、术中护理、术后观察及健康指导.结果:5例患者均成功植入CRT,2例成功植入CRT-D,1例拟植入CRT-D患者植入失败,改装埋藏式心脏复律除颤器.术后患者心功能状态、射血分数均较术前改善(P<0.01),QRS波变窄,未发生心脏压塞、电极脱位、切口不愈合等严重不良并发症,但其中1例术中出现急性左心衰竭,1例出现切口渗血.结论:CRT或CRT-D是治疗慢性顽固性心力衰竭的有效方法,围术期的良好护理是取得满意疗效的重要保证.

       

      Abstract: Objective:To investigate the perioperative nursing experience of severe chronic heart failure patients treated with cardiac resynchronization therapy(CRT) or cardiac resynchronization therapy-cardioverter defibrillator(CRT-D).Methods:The data of the preoperative, intraoperative and postoperative nursing in 8 chronic heart failure patients treated with CRT or CRT-D were retrospectively analyzed.Results:The operations in 5 patients treated with CRT, 2 patients treated with CRT-D and 1 patient treated with CRT-D were unsuccessful, and then treated with implantable cardioverter defibrillator ICD were successful.Compared with before treatment, the cardiac function and ejection fraction of all cases were improved after treatment(P<0.01).The QRS wave becoming narrow and no cardiac tamponade, electrode dislocation and incision non-healing in all patients were found, the acute left heart failure in 1 case and incision blood effusion in 1 case were found.Conclusions:The CRT or CRT-D for treating chronic intractable heart failure is an effective means, the perioperative good care is an important means to get better effects.

       

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