心电监护拔牙护理934例研究.docVIP

心电监护拔牙护理934例研究[摘要]目的探讨心电监护拔牙的手术效果、安全性及其护理要点。方法对934例需拔牙的心血管疾病患者在心电监护下拔牙，全程对患者进行护理和宣教。结果纳入本研究的934例患者中，913例顺利完成拔牙，21例发生血压升高、T波改变等，用药后缓解，并完成拔牙。结论心电监护拔牙为需拔牙的心血管疾病患者提供了一种安全有效的拔牙方法；护理是心电监护拔牙的重要组成部分，对降低手术风险具有积极的意义。 [关键词]心电监护；拔牙；护理 [中图分类号]R 782.2[文献标志码]A[doi]10.3969/j.issn.1673-5749.2012.04.011 Nursing of 934 cases of tooth extraction under the monitoring of electrocardiogramLiao Xuejuan, Zhao Forong.（Dept. of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu 610041, China） [Abstract]ObjectiveTo investigate the effect, complication and nursing key of tooth extraction under the monitoring of electrocardiogram. Methods934 cases of tooth extraction accompanying with angiocardiopathy were treated under the monitoring of electrocardiogram. All the patients were nursed in all the management. ResultsAmong the 934 cases, there was no any complication in 913 cases. There were some complications, such as high blood pressure, T wave changes, in 21 cases. Tooth extractions were finished after the patients had been given drugs and the symptom had disappeared. ConclusionTooth extraction under the monitoring of electrocardiogram provides a safe and effective method for the patients of angiocardiopathy who need tooth extraction. Nursing is an important part of tooth extraction under the monitoring of electrocardiogram and helpful to decrease the danger of operation. [Key words]monitoring of electrocardiogram；tooth extraction；nursing 随着中国逐渐步入老龄化社会，老年人群逐渐成为拔牙患者的重要组成部分。许多老年患者患有高血压、冠心病等心血管疾病，拔牙可能诱发这些心血管疾病的急性发作，从而对患者造成威胁[1-2]。近年来，四川大学华西口腔医院口腔颌面外科门诊针对这些患者开展了心电监护拔牙的专科门诊，取得了较好的治疗效果，提高了治疗的安全性。心电监护拔牙的护理具有其特殊性，现总结如下。 1研究对象和方法 选取四川大学华西口腔医院口腔颌面外科门诊2010年1月—2011年2月进行心电监护拔牙的患者为研究对象，共计934例。其中，男性患者522例，女性患者412例；患有高血压者352例，患有冠心病者274例，同时患有高血压和冠心病者216例，其他心血管疾病92例。 在术前对所有患者了解心血管疾病的病史和目前情况，并进行术前物资准备和心理辅导，促使患者放松；协助监护医生采用心电监护仪对患者的生命指征（心率、脉搏、呼吸频率、血压、血氧饱和度）和心电图监测5 min，确认患者全身情况平稳后，根据具体病情进行局部麻醉和拔牙，术中对患者生命指征和心电图进行持续监测，必要时据医嘱及时给予硝酸甘油等药物进行治疗，术后进行护理指导。