ICU左心室辅助装置植入术后患者控制器报警原因分析及对策  

Cause analysis and nursing intervention of controller alarm in ICU among patients after left ventricular assist device implantation

作　　者：耿丹丹 张伟 陆真 陈晴晴 赵彩萍 叶菊 管玉珍 GENG Dandan;ZHANG Wei;LU Zhen;CHEN Qingqing;ZHAO Caiping;YE Ju;GUAN Yuzhen

机构地区：[1]南京医科大学第一附属医院心脏大血管外科,南京市210029

出　　处：《中华急危重症护理杂志》2025年第4期466-470,共5页Chinese Journal of Emergency and Critical Care Nursing

基　　金：江苏省科教能力提升工程(ZDXK202230)。

摘　　要：目的总结分析12例左心室辅助装置植入术后控制器出现的报警数据,为制订针对性措施以提高护士对左心室辅助装置体外控制器报警的响应与处理能力提供依据。方法选取2021年7月1日—2023年8月9日在江苏省某三级甲等医院心脏大血管外科接受“左心室辅助装置植入术”的12例患者作为调查对象,分类总结他们在ICU期间左心室辅助装置体外控制器报警类型、人数比例、原因和当时实施的护理措施,再进行“抽吸报警”的亚组分析。结果12例患者在ICU住院期间共产生1080条报警。单电源供电报警占76.9%,抽吸报警占19.5%,其他还有单电池电量低和高功率报警。所有患者都发生了单电源供电报警,共831次;5例患者发生了抽吸报警,共211次;4例患者发生了单电池电量低报警,共36次;两例患者发生了高功率报警,共2次。抽吸报警组和未抽吸报警组患者的术前体重、体表面积、术前左心室舒张末内径和血泵转速差异无统计学意义,但术后左心室舒张末内径下降幅度比较,差异有统计学意义(P<0.05)。结论抽吸报警的发生率与左心室辅助装置植入术后左心室舒张末内径短期下降的幅度有密切关系。通过报警数据分析有助于掌握左心室辅助装置体外控制器的报警现状,制订针对性的干预措施。Objective To summarize and analyze the controller alarm data of 12 patients after implantation of left ventricular assist device(LVAD),so as to provide basis for formulating targeted measures to improve nurses’response and processing ability to left ventricular assist controller alarm.Methods A total of 12 patients who received implantation of LVAD in the Department of Cardiovascular Surgery of Jiangsu Province Hospital from July 1,2021 to August 9,2023 were selected as investigation objects,and their controller alarm types,percentage,causes and nursing measures during ICU were classified and summarized,and then subgroup analysis of"suction alarm"was performed.Results A total of 1080 alarms were generated during the ICU hospitalization among 12 patients.Single power supply alarm accounted for 76.9%,suction alarm accounted for 19.5%,the others included single battery low capacity and high power alarm.All of patients had a single power supply alarm with 831 times totally,5 people had suction alarm with 211 times totally,4 patients had single battery low capacity alarm with 36 times totally,and two persons had high power alarms with two times.There were no significant differences in preoperative body weight,body surface area,preoperative left ventricular end-diastolic diameter(LVEDD)and blood pump speed between suction alarm group and no suction alarm group,but there is a significant difference in the postoperative left ventricular end-diastolic diameter reduction(LVEDD-R)(P<0.05).Conclusion The incidence of suction alarm was closely related to the short-term decrease of LVEDD after LVAD implantation.The analysis of alarm data is helpful to grasp the alarm status of LVAD and formulate targeted intervention measures.

关 键 词：左心室辅助 控制器 ICU 报警 护理 

分 类 号：R473.6[医药卫生—护理学]