缩窄性心包炎患者行心包剥脱术后的心功能维护  

Cardiac function related nursing care for patients with constrictive pericarditis treated with pericardiectomy

作　　者：王咏琳 黄海东 王芳 李嘉欣[1] 宋亚敏[1] Wang Yonglin;Huang Haidong;Wang Fang;Li Jiaxin;Song Yamin(Department of Cardiac Surgical Intensive Care Unit One,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]广东省心血管病研究所,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,广东广州510080

出　　处：《护理学杂志》2024年第4期53-56,共4页Journal of Nursing Science

基　　金：广东省医学科学技术研究基金项目(A2020568)。

摘　　要：目的促进缩窄性心包炎患者行心包剥脱术后心功能恢复。方法针对33例行心包剥脱术的缩窄性心包炎患者术后出现的心功能不全甚至急性心力衰竭,以及困难脱机等临床表现,实施精细化管理出入量,合理使用正性肌力药物及机械装置,保持气道通畅,加强急性心功能不全的救护等措施。结果术后发生右心功能不全12例,低心排综合征10例,再次气管插管4例。本组患者呼吸机使用时间4~943 h(中位数45 h),ICU停留时间1~42 d(中位数4 d)。31例康复出院,2例因再次心脏手术后并发严重并发症自动转院。结论缩窄性心包炎患者心包剥脱术后易并发心功能不全,术后全方位综合护理有利于患者心功能恢复。Objective To boost the recovery of cardiac function of patients with constrictive pericarditis receiving pericardiectomy.Methods Concerning the postoperative clinical manifestations of cardiac insufficiency,acute heart failure and difficult weaning,33 patients with constrictive pericarditis who underwent pericardiectomy were treated with management strategies,including fine management of intake and output,rational use of inotropic agents and mechanical devices,maintenance of airway patency,and strengthening of nursing rescue and cooperation for acute cardiac insufficiency.Results There were 12 cases of right heart dysfunction,10 cases of low cardiac output syndrome and 4 cases of reintubation.The mechanical ventilator service time of the patients was 4-943 h(median 45 h)and the ICU stay time was 1-42 d(median 4 d).After meticulous treatment and nursing,31 patients reco-vered and were discharged and 2 patients were automatically transferred to another hospital due to serious complications after re-cardiac surgery.Conclusion Patients with constrictive pericarditis may develop cardiac insufficiency,after pericardietomy.Implementing comprehensive nursing care is beneficial to recovery of patients′cardiac function.

关 键 词：缩窄性心包炎 心包剥脱 低心排综合征 心功能不全 房颤 主动脉内球囊反搏 机械通气 外科护理 

分 类 号：R473.6[医药卫生—护理学]