心脏外科术后电风暴患者的护理  

Nursing care for patients with electrical storm after cardiac surgery

作　　者：刘志昌 凌云 林琼瑜[1] 朱苏敏 Liu Zhichang;Ling Yun;Lin Qiongyu;Zhu Sumin(Cardiac Surgery Intensive Care Unit 1,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Southern Medical University,Guangzhou 510080,China)

机构地区：[1]南方医科大学附属广东省人民医院、广东省医学科学院心外重症监护一科,广州510080

出　　处：《国际医药卫生导报》2023年第13期1896-1899,共4页International Medicine and Health Guidance News

基　　金：广东省人民医院(广东省医学科学院)护理科研基金(DFJH202128)。

摘　　要：目的总结心脏外科术后电风暴患者的护理经验。方法选取2020年4月至2022年2月入住广东省人民医院的共7例心脏外科术后发生电风暴患者为研究对象,其中男性6例,女性1例,年龄(51.10±18.67)岁,回顾性分析心脏外科患者术后发生电风暴的护理过程,包括电风暴危险因素识别、血流动力学监测与生命支持、密切关注电解质、抗心律失常药物使用的护理、适度镇静与环境管理、皮肤护理、心理护理,对于循环难以稳定的患者予体外膜肺氧和支持治疗。结果经积极救治与护理,5例患者的电风暴均得以纠正;1例患者因反复室颤,予体外膜肺氧合支持治疗后,恢复窦性心律;1例患者抢救无效死亡。结论电风暴可发生在心脏外科手术后任何时间,严密观察心律变化,及时发现、积极治疗及有效的护理措施是稳定患者病情的关键。Objective To summarize the nursing experiences for patients with electrical storm after cardiac surgery.Methods A total of 7 patients with electrical storm after cardiac surgery admitted to Guangdong Provincial People's Hospital from April 2020 to February 2022 were selected as the study objects,including 6 males and 1 female,aged(51.10±18.67)years.The nursing process for patients with electrical storm after cardiac surgery was retrospectively analyzed,including identification of electrical storm risk factors,hemodynamic monitoring and life support,paying close attention to electrolytes,nursing of antiarrhythmic drug use,moderate sedation and environmental management,skin care,psychological care,and extracorporeal membrane oxygen and supportive treatment to patients with difficult circulation stability.Results After active treatment and nursing,electrical storm was corrected in 5 patients;1 patient was treated with extracorporeal membrane oxygenation and returned to sinus rhythm due to recurrent ventricular fibrillation;1 patient died after rescue.Conclusions Electrical storm can occur at any time after cardiac surgery.Careful observation on rhythm changes,timely detection,active treatment,and effective nursing measures are the keys to stabilize the patients'illness.

关 键 词：电风暴 心脏外科 重症监护 护理 

分 类 号：R473.6[医药卫生—护理学]