体外膜肺氧合联合持续肾脏替代治疗救治1例爆发性心肌炎患者的护理  

作　　者：陈晨[1] 沈蕴之[2] 

机构地区：[1]复旦大学附属华山医院心内外科,上海200040 [2]复旦大学附属华山医院,200438

出　　处：《湖南中医药大学学报》2018年第A01期734-734,共1页Journal of Hunan University of Chinese Medicine

摘　　要：总结1例重症心肌炎合并恶性心律失常应用体外膜肺氧合(Extracorporeal Membrane Oxygenation ECMO)治疗以及持续肾脏替代治疗(Continuous Renal Replacement Therapy CRRT)的护理经验。疾病初期通过严密的病情观察,迅速、有效开始ECMO干预;在ECMO运行期间密切监测心率、血压、凝血功能,并执行严格的液体管理,及时观察和处理心律失常、低血压及肢端循环障碍等各类并发症,同时严格实施体外循环管路管理,积极配合医生的临床治疗。该患者经过ECMO和CRRT治疗后,病情逐渐稳定并顺利出院。This study retrospectively summarizes the nursing care of an adult with acute fulminant myocarditis treated by extracorporeal membrane oxygenation(ECMO)and continuous renal replacement therapy(CRRT).At the early stage of the disease,ECMO intervention was initiated quickly and effectively.During ECMO stage,nursing care focused on monitoring of heart rate,blood pressure,coagulation functions,strict fluid management,timely detection and treatment of arrhythmias,hypotension,limb end circulatory disorders and other complications,as well as strict cardiopulmonary bypass pipeline management.The patient was successfully weaned from ECMO and CRRT,and discharged with improvement.

关 键 词：重症心肌炎 恶性心律失常 心源性休克 体外膜肺氧合 急性肾功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学]