一例体外膜肺氧合治疗Tako-Tsubo心肌病并发心源性休克患者的护理  

Nursing care of a case of cardiogenic shock complicated with Tako-Tsubo cardiomyopathy treated by extracorporeal membrane pulmonary oxygen

作　　者：鲁涓涓[1] 曾妃[1] 金小娟[1] 周艳[1] Lu Juanjuan;Zeng Fei;Jin Xiaojuan;Zhou Yan(Binjiang Comprehensive Care Unit, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China)

机构地区：[1]浙江大学医学院附属第二医院滨江综合监护室,310000

出　　处：《中国实用护理杂志》2019年第16期1273-1277,共5页Chinese Journal of Practical Nursing

摘　　要：目的介绍1例Tako-Tsubo心肌病并发心源性休克患者应用体外膜肺氧合(ECMO)治疗的护理,提高人们对Tako-Tsubo心肌病及ECMO的认识。方法成立ECMO护理组配合医疗组对Tako-Tsubo心肌病患者应用ECMO救治,专人护理,明确分工,严密监测生命体征及Tako-Tsubo心肌病的相关指标,做好ECMO护理并预防并发症。结果ECMO上机30min血气分析情况较前改善,ECMO上机后Tako-Tsubo心肌病的相关指标逐渐好转,2d后左心室射血分数逐渐恢复,室壁运动逐渐恢复至正常。3d后血清学生物标记物数值明显下降,并逐渐恢复正常。4d后停ECMO治疗并拔除ECMO置管,5d后脱机拔除气管插管。住院治疗41d患者病情稳定,康复出院。结论迅速有效的ECMO护理团队是患者成功救治的重要保障,密切病情观察、良好的团队协作和合理分工可以有效改善患者的预后。Objective To introduce the nursing care of a case of Tako-Tsubo cardiomyopathy treated with extracorporeal membrane oxygenation (ECMO) and to improve the understanding of Tako-Tsubo cardiomyopathy and ECMO. Methods ECMO nursing group combined with medical treatment group was established to treat Tako-Tsubo cardiomyopathy patients with ECMO, special nursing, division of labor, close monitoring of vital signs and related indicators of Tako-Tsubo cardiomyopathy, ECMO nursing and prevention of complications. Results ECMO on board for 30 minutes, blood gas analysis was improved, the relative indexes of Tako-Tsubo cardiomyopathy were gradually improved after ECMO, the left ventricular ejection fraction gradually recovered after 2 days, and the wall motion gradually returned to normal. After 3 days, the value of serological biomarkers decreased obviously. After 4 days, ECMO therapy was stopped and ECMO tube was removed. After 5 days, tracheal intubation was removed. The patient was stable in condition and discharged from hospital after 41 days of inpatient treatment. Conclusions A rapid and effective ECMO nursing team is an important guarantee for the successful treatment of patients. Close observation of the condition, good team cooperation and reasonable division of labor can be effective. To improve the prognosis of patients.

关 键 词：护理 心源性休克 TAKO-TSUBO心肌病 体外膜肺氧合 

分 类 号：R473.5[医药卫生—护理学]