1例行左心室辅助装置植入联合冷冻消融术患者的护理  

Perioperative care of a patient implanted left ventricular assist device combined with cryoablation

作　　者：彭斯 张霞[1] 周林 刘双双[2] 周新民[2] 李建明[2] PENG Si;ZHANG Xia;ZHOU Lin;LIU Shuangshuang;ZHOU Xinmin;LI Jianming

机构地区：[1]中南大学湘雅二医院临床护理学教研室,长沙市410000 [2]中南大学湘雅二医院心血管外科,长沙市410000

出　　处：《中华护理杂志》2024年第22期2785-2789,共5页Chinese Journal of Nursing

基　　金：2024年度湖南省自然科学基金项目(2024JJ9208)。

摘　　要：总结1例心脏再同步化治疗除颤器植入术后反复放电致电池电量即将耗尽患者行左心室辅助装置植入联合冷冻消融术的护理经验。护理要点:预防心律失常,积极处理电风暴;精细化容量管理,避免水钠潴留;制订个性化抗凝方案,降低出血与血栓形成风险;重视经皮缆线的维护,预防切口感染;全程心理疏导,改善情绪状态;线上线下定期随访,保障远期生活质量。经过精心的治疗和护理,术后23 d,患者顺利出院,出院后随访,情况良好。To summarize the nursing experience of a patient with cardiac resynchronization therapy defibrillator(CRT-D)implantation who was about to deplete battery due to repeated discharge after implantation and underwent left ventricular assist device implantation combined with cryoablation.Key points of care were as follows.To begin with,we actively managed arrhythmias and electric storm.Secondly,we carried refined capacity management to avoid water and sodium retention.Thirdly,we formulated personalized anticoagulation programs to reduce the risk of bleeding and thrombosis.Then,the pump line infection should be prevented as early as possible.At the whole stage,we provided psychological counseling to improve emotional state.After discharge,regular follow-up was carried out through online and offline method to ensure quality of life in the long term.After careful treatment and nursing care,23 days after surgery,the patient was discharged smoothly,and good follow-up after discharge.

关 键 词：终末期心力衰竭 室性心律失常 左心室辅助装置 冷冻消融 护理 

分 类 号：R473.5[医药卫生—护理学]