目的 总结6例植入连续血流左心室辅助装置患者的术后护理经验,为提高植入连续血流左心室辅助装置术后的护理水平提供参考。方法 给予循环系统的监测和护理,抗凝管理,经皮泵缆线的护理,体外控制器的自我管理,心脏康复运动训练,镇痛镇静的护理,出院指导等护理。结果 5例患者康复出院,1例患者术后17 d后因低心排、感染性休克死亡。通过门诊和电话随访出院5例患者,设备运转正常,生存质量可。结论 连续血流左心室辅助装置植入术手术复杂,尚处于临床试验阶段,护理人员在掌握患者原始疾病的基础上,需熟知其术后的护理难点和要点,全方位关注患者术后整体病情,提高术后生存率和生存质量。
关键词
心力衰竭 /
终末期 /
连续血流左心室辅助装置 /
抗凝管理 /
心脏康复运动 /
术后护理
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参考文献
[1] 张岩,孙寒松,胡盛寿.左心室辅助血泵及其临床应用研究进展[J].中国胸心血管外科临床杂志,2017,24(2):152-155. DOI:10.7507/1007-4848.201503048.
[2] Pavlovic NV, Randell T, Madeira T,et al.Risk of Left Ventricular Assist Device Driveline Infection: A Systematic Literature Review[J].Heart Lung, 2019,48(2):90-104. DOI:10.1016/j.hrtlng.2018.11.002.
[3] DeVore AD,Patel PA,Patel CB.Medical Management of Patients with a Left Ventricular Assist Device for the Non-Left Ventricular Assist Device Specialist[J]. JACC Heart Fail,2017,5(9):621-631. DOI:10.1016/j.jchf.2017.06.012.
[4] Nassif ME, Tibrewala A, Raymer DS, et al.Systolic Blood Pressure on Discharge after Leftventricular Assist Device insertion Is Associated with Subsequent Stroke[J].J Heart Lung Transplant,2015, 34(4):503-508. DOI:10.1016/j.healun.2014.09.042.
[5] Gopinathannair R, Cornwell WK, Dukes JW,et al.Device Therapy and Arrhythmia Management in Left Ventricular Assist Device Recipients: A Scientific Statement from the American Heart Association[J]. Circulation, 2019,139(20):e967-e989. DOI:10.1161 /CIR.0000000000000673.
[6] Pavlovic NV, Randell T, Madeira T, et al.Risk of Left Ventricular Assist Device Driveline Infection:A Systematic Literature Review[J]. Heart Lung,2019,48(2):90-104. DOI:10.1016/j.hrtlng.2018.11.002.
[7] Bobenko A, Schoenrath F, Knierim JH, et al.Exercise Training in Patients with a Left Ventricular Assist Device(Ex-VAD): Rationale and Design of a Multicentre, Prospective, Assessor-blinded, Randomized, Controlled Trial[J]. Eur J Heart Fail,2019,21(9):1152-1159. DOI:10.1002/ejhf.1431.
[8] 孙福月,杨宁,李超,等.镇静镇痛集束护理对ICU气管插管患者谵妄的影响[J].护理学报,2018,25(10):58-61. DOI:10.16460/j.issn1008-9969.2018.10.058.
[9] 徐婷婷,居敏洁,邵珍珍,等.床旁连续性血液净化治疗重症急性胰腺炎患儿的护理[J].中华护理杂志,2019,54(4):575-577. DOI:10.3761/j.issn.0254-1769.2019.04.020.
基金
华中科技大学同济医学院附属协和医院药剂护专项基金（02.03.2019-189）
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