急性心肌梗死合并室间隔破裂行联合介入治疗的围术期护理对策  

Perioperative Nursing Stragegy of Combined Interventional Treatment for Acute Myocardial Infarction Combined with Ventricular Septal Rupture

作　　者：刘莹[1] 苏静[1] 曹荣[1] 任红[1] 李菲[1] 

机构地区：[1]沈阳军区总医院心内科,沈阳110016

出　　处：《解放军护理杂志》2009年第11期39-40,共2页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨急性心肌梗死合并室间隔破裂行经皮冠状动脉介入治疗（percutaneoue caronary intervention,PCI）联合室间隔封堵治疗的患者在围术期护理方面应注意的问题及相应护理方法．从而为此类患者提供有效的护理方案。方法整理并总结2001年10月至2008年11月我院收治的急性心肌梗死合并室间隔破裂行PCI联合室间隔封堵治疗的13例患者的资料。结果13例患者住院期间10例存活（住院存活率为76．9％），3例Killip IV级患者死亡，其中1例死于脑出血、2例心性死亡（住院病死率为23．1％）。随访2～66个月。平均（37±2．3）个月．出院患者均存活；门诊超声心动图复查提示．心功能均获得明显改善，与入院时比较，改善1级3例、2级4例、3级3例。围术期无护理并发症发生。结论心肌梗死合并室间隔破裂患者行联合介入治疗。可获得较好的存活率，并可明显改善心功能，严密的病情监测与急救、精心的护理可使患者安全度过联合介入治疗的围术期。Objective To explore effective perioperative nursing methods and their related factors in patients with acute myocardial infarction complicated with ventricular septal rupture after occlusion of ventricular septal defect with percutaneous coronary intervention（PCI）. Methods The medical records of 13 in-patients with acute myocardial infarction complicated with ventricular septat rup- ture after occlusion of ventricular septal defect with PCI from Oct. 2001 to Nov. 2008 were analyzed. Results Of the 13 in-patients, 10 patients （76. 9%） survived ,and 3 （23. 1%） Killip IV patients died including 1 death case for cerebral hemorrhage and 2 for cardiac death. The discharged patients were followed-up for 2--66 months（mean,37±2.3 months ） and they all survived. The echocardiographic diagnosis indicated that the patients＇ cardiac functions were improved. Compared with the conditions in the hospital,3 Ⅰlevel patients,4 Ⅱ level patients and 3 Ⅲ level patients were all improved. No complication was observed during the perioperative period. Conclusion With combined interventional treatment, the prognosis and cardiac function of the patients with acute myocardial infarction complicated with ventricular septal rupture can be improved. An intensive nursing and close observation and emergent rescuing can enhance postoperative rehabilitation of the patients during the perioperative period.

关 键 词：急性心肌梗死 室间隔破裂 护理 

分 类 号：R542.22[医药卫生—心血管疾病]