暴发性心肌炎患儿行清醒体外膜肺氧合治疗的护理  

Awake extracorporeal membrane oxygenation for children with fulminant myocarditis: nursing care

作　　者：朱艳娟 洪小杨 赵喆 冯秋霜 王自珍 Zhu Yanjuan;Hong Xiao-yang;Zhao Zhe;Feng Qiushuang;Wang Zizhen(Intensive Care Unit,Department of Pediatric Medicine,the Seventh Medical Center of the Chinese People′s Liberation Army General Hospital,Beijing 100007,China)

机构地区：[1]中国人民解放军总医院第七医学中心儿科医学部重症医学科,北京100007

出　　处：《护理学杂志》2023年第4期37-39,44,共4页Journal of Nursing Science

基　　金：国家重点研发计划课题(2021YFC270105);首都卫生发展科研专项项目(2020-2-5093)。

摘　　要：对5例暴发性心肌炎患儿行清醒状态下静脉-动脉模式体外膜肺氧合治疗,在实施体外膜肺氧合前行唤醒护理,治疗期间加强病情观察、疼痛护理、早期活动引导、人文关怀护理等。结果1例患儿治疗72 h后出现室性心动过速,再次行气管插管机械通气,其余4例患儿治疗50~163 h后顺利撤机,转普通病房进一步康复治疗。5例患儿清醒体外膜肺氧合治疗期间均无导管移位、脱落等不良事件和相关并发症发生。Five children with fulminant myocarditis rescued with awake veno-arterial extracorporeal membrane oxygenation(ECMO). Nursing care included waking up the patient prior to ECMO cannulation, continuous monitoring of patient condition during ECMO course, pain relief, early mobilization, humanistic care, etc. Four children were successfully weaned from ECMO after 50-163 h and transferred to the general ward for further rehabilitation, whereas the other one developed ventricular tachycardia at 72 h after initiation of ECMO and received mechanical ventilation again. Adverse events(i.e.,dislocation of cannulas or extubation) and complications related to ECMO therapy were not observed.

关 键 词：儿童 急性暴发性心肌炎 体外膜肺氧合 清醒 疼痛 人文关怀 机械通气 重症护理 

分 类 号：R473.72[医药卫生—护理学]