2例扩张型心肌病患儿行原位心脏移植的围手术期护理  

Perioperative nursing care of 2 children with dilated cardiomyopathy undergoing orthotopic heart transplantation

作　　者：陈燕 顾莺 徐昱璐 叶岚 王慧美[4] 傅丽丽[5] 宓亚平[1] 叶明[4] 刘芳 CHEN Yan;GU Ying;XU Yulu;YE Lan;WANG Huimei;FU Lili;MI Yaping;YE Ming;LIU Fang

机构地区：[1]复旦大学附属儿科医院心脏重症监护病房,上海市201102 [2]复旦大学附属儿科医院护理部,上海市201102 [3]复旦大学附属儿科医院心内科,上海市201102 [4]复旦大学附属儿科医院心外科,上海市201102 [5]复旦大学附属儿科医院社会工作部,上海市201102

出　　处：《中华护理杂志》2024年第21期2653-2658,共6页Chinese Journal of Nursing

基　　金：上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22023240)

摘　　要：总结2例扩张型心肌病患儿行原位心脏移植的围手术期护理经验。术前护理要点:评估心力衰竭症状,为制订护理方案提供依据;加强心力衰竭护理,改善各器官功能。术后护理要点:监测血流动力学,稳定血液循环;维护右心功能,预防急性右心衰竭;加强肺部护理,预防呼吸系统感染;合理应用免疫抑制剂,识别急性排斥反应;采用程序式喂养方式,给予早期肠内营养;实施早期康复训练,加速术后康复;提供社会心理支持,加强出院宣教及随访。经多学科团队精心的诊疗及护理后,2例患儿分别于术后20、30 d康复出院。出院后随访,均恢复良好。This study summarized the nursing experience of 2 pediatric heart transplant surgeries.Perioperative care included preoperative maintenance of cardiac function,volume management,infection prevention measures,and psychological preparation.Early postoperative care involved circulatory monitoring,management of right heart dysfunction,use of immunosuppressants,observation of rejection reactions,control of postoperative infections,nutritional support,psychological care,and home continuity care.The postoperative rehabilitation effect of the children is satisfactory after multi-team special treatment and nursing care.The postoperative hospitalization time for the 2 patients were 20 and 30 days.After discharge,2 patients showed good recovery during follow-up.

关 键 词：心肌病 扩张型 心脏移植 儿科护理学 围手术期护理 

分 类 号：R473.72[医药卫生—护理学]