心脏瓣膜置换术后发生精神障碍原因研究及护理.docVIP

心脏瓣膜置换术后发生精神障碍原因研究及护理【摘要】 目的 分析心脏瓣膜置换术后发生精神障碍的原因,以便医护密切协作,采取防治措施。方法 对自2005年12月至2008年12月实施的50例心脏瓣膜置换术患者,进行回顾性分析,根据临床表现、手术过程及术后ICU监测情况,分析发生精神障碍的因素,依个体不同情况进行相应的治疗和护理。结果 本组50例,死亡2例(4%);术后发生精神障碍5例(10%),均在术后7～15 d治愈。出院后随访1～4年,5例均无再复发。结论 心脏瓣膜置换术后发生精神障碍的原因与体外循环(CPB)、环境及个体精神状态密切相关。采用精神干预,适当药物治疗,妥善护理,可在短期内治愈。 【关键词】 心脏瓣膜置换术;体外循环;手术后并发症;精神障碍 The cause analysis and care of psychosis disorders after cardiac valve replacement LIU Shi-cai.Cardiovascular Surgery Department, Central Hospital of Zhoukou City, Henan Province 466000,China 【Abstract】 ObjectiveIn order to improve the collaboration of health care and take preventive and treatment measure,analyzing the cause of mental disorder after cardiac valve replacement surgery.Methods To retrospectively analyze 50 patients who had suffering from the mental disorder after cardiac valve replacement performed in the period of December 2005 to December 2008.Based on the clinical performance,surgical procedures and postoperative ICU monitoring,analyze the factors of psychosis disorder causation;according to individual patient,take corresponding individual treatment and care.Results 50 cases of this group, 2 cases of death (4%);5 cases of psychosis disordersafter operation (10%),which were cured in 7-15 days.1-4 years post-discharge follow-up, 5 patients had no further recrudescence.Conclusion The causation of psychosis disorder after cardiac valve replacement is closely related to cardiopulmonary bypass (CPB), the environment and the individual mental state. That can be cured in the short term with the mental intervention treatment,appropriate drug therapy and proper care. 【Key words】 Cardiac valvereplacement; Carduopulmonarybypass; Postoperative complication; Psychosis disorder 心脏瓣膜置换手术后发生精神障碍是较常见的并发症,河南省周口市中心医院自2005年12月至2008年12月共施行心脏瓣膜置换手术50例,其中5例术后发生精神障碍(10%)。经医护及患者亲属协作,全部治愈出院。本文对发生精神障碍的原因进行分析,并针对原因进行综合治疗及护理。 1 资料及方法 1.1 一般资料 本组50例,其中男21例,女29例。年龄24～63岁,平均(37.2±4.2)岁。风湿性心脏病46例,感染性心内膜炎2例,主动脉窦瘤破裂并主动脉瓣关闭不全(AI)1例,主动脉瓣