老年退行性心脏瓣膜病心律失常临床观察及护理.doc

老年退行性心脏瓣膜病心律失常临床观察及护理（广西北海市人民医院 536000） 【摘要】目的：探讨SDHVD心律失常的护理对策。方法：对75例SDHVD住院患者进行严密心电监护，观察心率的频率、节律、类型、时间，患者的活动状态并做好护理。结果：在75例SDHVD患者中出现心律失常46例，给予抗心律失常药物治疗和采取有效的护理措施，均好转出院。结论：SDHVD发病隐袭，缺乏特异性的临床表现，目前尚无有效的药物治疗，心律失常是SDHVD最常见的并发症，临床观察护理尤为重要，可减少恶性心律失常的发生，为诊治提供依据。 【关键词】老年退行性心脏瓣膜病；心律失常；观察护理 Clinical Observation and Nursing care on Arrhythmia of Degenerative Heart Valvular Desease ShiHuiBi 【Abstract】Objective To evaluate the nursing countermeasure of SDHVD on arrhythmia.Methods Close ECG monitoring were given to 75 SDHVD inpatients,and the parameters such as heart rate,rhythm,type,duration of arrhythmia as well as activity situation of patients were observed,and carefully nursing were provided at the same time.Rusults We found that arrhythmia occurred in 46 cases of 75 SDHVD patients,and they were all discharged from hospital with improvement after treatment with anti-arrhythmia medication and effective nursing measure.Conclusions Until now,no treatment has shown efficacy on SDHVD because of insidious onset of the desease and lack of special clinical manifestations.Since arrhythmia is the most common complication of SDHVD,we think clinical observation and nursing care on arrhythmia would be very important to reduce the m alignant arrhythmia occurrence ,provide basis for diagnosis and remedy of SDHVD at the same time. 【Key words】 SDHVD；arrhythmia； Observation Nursing 【中图分类号】R473【文献标识码】A【文章编号】1008-6455（2011）06-0024-01 老年退行性心脏瓣膜病（SDHVD）又称老年钙化性心脏瓣膜病，是随着年龄增长，心脏结缔组织退行性变而纤维化、钙化从而使瓣膜和（或）其支架的功能异常引起的一组心脏病，它不仅侵犯心脏瓣膜还损害心脏传导系统，引起各种心律失常，甚至导致猝死［1］。本病发病隐袭，缺乏特异性的临床表现，临床上易于误诊和漏诊，且目前尚无有效的药物治疗，所以临床观察护理显得尤其重要。本文对75例SDHVD患者通过严密监护，对出现心律失常的46例患者给予积极治疗和观察护理，取得较好效果，报道如下。 1资料与方法 1.1 研究对象:选择2006年1月-2009年12月来我院住院的经心脏彩超检查确诊的SDHVD患者，SDHVD诊断参照徐乃昌等［2］提出的心脏彩超诊断标准，采用彩色多普勒超声心动仪，依据在不同切面上二尖瓣及主动脉瓣的瓣膜及／或瓣环有致密回声增强增、厚或团块回声进行诊断；符合SDHVD诊断患者75例，其中男52例、女23例，年龄60～89岁，平均（69.5±7.80）岁。均经Holter、胸部x线、心脏彩超检查，排除其他心血管疾病。 1.2 方法: 对75例SDHVD住院患者进行严密心电监护24小时以上，观察心率的频率、节律、类型、时间，患者的活动状态，并做好护理记录。对发生心率