高龄肺癌患者全肺切除术后心律失常的因素分析及临床护理  

Factors analysis and clinical care of arrhythmia in advanced age lung cancer patients after pneumonectomy

作　　者：孟亚熙 

机构地区：[1]铜川市矿务局中心医院普通外科,陕西省727000

出　　处：《中国心血管病研究》2014年第3期250-252,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨高龄肺癌患者全肺切除术后并发心律失常的原因并总结临床护理措施.方法 收集近年来于我院普通外科行全肺切除的71例肺癌患者的临床资料,对高危因素进行分析,同时总结相关护理措施.结果 术后1～3 d心律失常发生率为52.1％（37/71）.多因素分析表明,术前合并心血管基础病、心电图异常、重度肺功能障碍、术中出血量多（≥500 ml）、术后血清钾低（≤4.0 mmol/L）均属于高龄肺癌患者全肺切除术后并发心律失常的高危因素（P＜0.05）.手术时长及性别与术后发生心律失常的发生无显著相关性（P＞0.05）.强化术前健康教育、严格手术适应证、充分供氧、预防并改善缺氧、纠正电解质紊乱、有效止痛及持续心电监护等均是有效的护理措施.结论 高龄肺癌患者全肺切除术后心律失常发生与术前心血管基础病、心电图异常、重度肺功能障碍等有关,在因素分析基础上开展有效的临床护理对预防此类心肺并发症的发生有重要意义.Objective To study the factors analysis and clinical care of arrhythmia in advanced age lung cancer patients after pneumonectomy.Methods 1 cases of lung cancer patients receiving pneumonectomy surgery in general surgery of central hospitalwere collected,the risk factors and the related nursing carried out were analyzed.Results The incidence of arrhythmia was 52.1％（37/71） postoperative 1 to 3 days.Multi-factor analysis showed that combining with cardiovascular disease,abnormal electrocardiogram （ecg）,severe pulmonary dysfunction,large intraoperative blood loss （≥500 ml） and lower postoperative serum potassium （≤4.0 mmol/L） were high risk factors of arrhythmia after pneumonectomy for lung cancer patients （P＜0.05）.The operation time and gender were no significant correlated with the incidence of pestoperative arrhythmia（P＞0.05）.Strengthening preoperative health education,strict operation indication,adequate oxygen,preventing and improving hypoxia,correcting electrolyte disorder,effective pain relief and continuous monitoring were effective nursing measures.Conclusion Pneumonectomy for lung cancer patients is a risk factor for incidence of arrhythmia.On the basis of factor analysis it is effective to carry out clinical care to prevent such cardiopulmonary complications.

关 键 词：肺癌 全肺切除术 心律失常 护理 

分 类 号：R541.7[医药卫生—心血管疾病]