左心室辅助装置植入患者围手术期的循证护理实践  

Perioperative evidence-based care practice for patients with implantable left ventricular assist devices

作　　者：陈霞[1] 黄翱黎 朱旭菁 胡敏 杨巧珍 冯洁惠[2] CHEN Xia;HUANG Aoli;ZHU Xujing;HU Min;YANG Qiaozhen;FENG JieHui

机构地区：[1]浙江大学医学院附属第一医院心脏大血管外科,杭州市310003 [2]浙江大学医学院附属第一医院护理部,杭州市310003

出　　处：《中华急危重症护理杂志》2025年第2期210-213,共4页Chinese Journal of Emergency and Critical Care Nursing

基　　金：浙江省医药卫生科技计划(2022KY741)。

摘　　要：目的对8例终末期心力衰竭患者制订并实施植入左心室辅助装置围手术期循证护理方案。方法在多学科协作基础上,针对围手术期护理重点和难点问题,计算机检索相关指南、系统评价和专家共识,对证据进行评价和整合后,将其应用于8例终末期心力衰竭行植入左心室辅助装置术患者。结果共纳入9篇文献,其中临床决策1篇、专家共识6篇、指南1篇、队列研究1篇;结合患者实际临床问题及多学科团队建议制订针对性护理方案,包括目标导向性循环管理、动态化抗凝管理、肠梗阻并发症预警、传动系统感染管理、器械报警管理。经过35~68 d的治疗及康复,患者各项功能恢复良好出院。结论针对植入左心室辅助装置患者,运用循证方法为患者提供科学、有效的护理措施,有助于促进患者康复。Objective To develop and implement a perioperative evidence-based care protocol for 8 patients with end-stage heart failure with implantable left ventricular assist devices(LVAD).Methods Based on multidisciplinary collaboration,addressing the priorities and difficulties of care,we searched relevant guidelines,systematic reviews and expert consensus.After evaluation and integration of evidence,it was applied to 8 patients with end-stage heart failure undergoing LVAD implantation.Results A total of 9 articles were finally included,including a clinical decision,six expert consensuses,a guideline and a cohort study.Based on the actual clinical problems of patients and the suggestion of multidisciplinary team,nursing plans were formulated,including goal-oriented circulation management,dynamic anticoagulation management,early warning of intestinal obstruction complications,transmission system infection management,device alarm management.After 35-68 d of treatment and rehabilitation,all functions of the patient recovered well and they were discharged.Conclusion For patients with LVAD implantation,evidence-based methods are used to provide scientific and effective nursing measures,which promote patient rehabilitation.

关 键 词：终末期心脏病 左心室辅助装置 循证护理学 围手术期护理 

分 类 号：R473.5[医药卫生—护理学]