老年肺心病合并心力衰竭患者临床护理研究  

Clinical Observation and Nursing Care for Old Patients with Cor Pulmonale and Heart Failure

作　　者：江月娥[1] 陈少娟[1] 段红萍[1] 彭剑芳[1] 

机构地区：[1]广东省肇庆市第一人民医院呼吸内科,526021

出　　处：《中华全科医学》2010年第4期517-518,共2页Chinese Journal of General Practice

摘　　要：目的总结肺源性心脏病合并心力衰竭的护理经验。方法对29例老年肺源性心脏病心力衰竭患者进行早期症状与体征的观察和评估,动态心电监护、血氧饱和度监测、病情观察,建立静脉通道,安全用药,加强呼吸道管理及积极防治肺部感染,严密监测水电解质及酸碱平衡,加强夜间护理查房,及时发现心律失常,实施抢救和护理。结果治疗前后HR、R及PaO2、PaCO2及尿量比较差异有统计学意义(P<0.01和P<0.05)。纠正了低氧血症,降低病死率。29例患者中死亡3例。结论在护理中,严密观察病情和心力衰竭早期症状与体征,动态心电监护和血氧饱和度监测,以及呼吸道管理是降低本病病死率的关键性护理措施,加强夜间护理查房及监测水电解质及酸碱平衡,对于减少并发症的发生至关重要。Objective To sum up the nursing experience of patients with cor pulmonale and heart failure.Methods 29 old patients of cor pulmonale with heart failure were enrolled in this study.The nursing methods,such as early observation and assessment for symptom and signs,the dynamic heart rate monitor,detection of oxyhemoglobin saturation,observation of the condition of patients,building the vein passage,safe using of medicines,reinforcing the management of respiratory tract and keeping out pulmonary infection energetically,monitoring the water-electrolyte and acid base equilibrium strictly,strengthening the evening rounds,were performed.The arrhythmia was found out in time,and the rescue measures and nursing care carried out.Results The differences in HR and R,PaO2 and PaCO2,and urinary volume was obviously before and after the treatment（P〈0.01 or P〈0.05）.The hypoxemia was improved,and the death rate was decreased（3/29）.Conclusion During the nursing care,observing the condition,observing and assessing their early symptom and signs,using the dynamic heart rate monitor,monitoring the oxyhemoglobin saturation and reinforcing the management of respiratory tract are the critical nursing measures to reduce the death rate;monitoring the water-electrolyte and acid base equilibrium strictly and strengthening the evening rounds are the most important to reduce complications in old patients with cor pulmonale and heart failure.

关 键 词：慢性肺源性心脏病 心力衰竭 护理研究 

分 类 号：R473.5[医药卫生—护理学] R541.5[医药卫生—临床医学]