心脏瓣膜术后严重并发症护理策略.docVIP

心脏瓣膜术后严重并发症护理策略 　　[摘要] 目的 探讨心脏瓣膜术后严重并发症的预防及护理措施。方法 回顾性分析沈阳军区总医院2015年11月―2016年11月对59例心脏瓣膜术后出现严重并发症患者实施的护理过程。 结果 ICU监护期间出现的严重并发症59例，发生率为9.0%。其中，低心排出量综合征25例，发生率为3.8%；严重心律失常23例，发生率为3.5%；急性肾功能不全7例，发生率为1.1%；左心室破裂4例，发生率为0.6%；无心包压塞病例。死亡8例，其中，低心排出量综合征2例，严重心律失常1例，急性肾功能不全致多器官脏器衰竭2例，左心室破裂3例。结论 早期预防、准确诊断、及时处理、精心护理是减少心脏瓣膜术后严重并发症，提高手术成功率的关键。 　　[关键词] 心脏瓣膜；并发症；预防；护理 　　[中图分类号] R473 [文献标识码] A [文章编号] 1674-0742（2017）04（c）-0166-04 　　[Abstract] Objective To discuss the prevention and nursing measures of severe complications after the cardiac valve surgery. Methods 59 cases of patients with severe complications after the cardiac valve surgery admitted and treated in our hospital from November 2015 to November 2016 were selected and the nursing course of the patients was retrospectively analyzed. Results Three were 59 cases with severe complications in ICU， and the incidence rate was 9.0%， and there were 25 cases with low cardiac output syndrome， and the incidence rate was 3.8%， 23 cases with severe arrhythmia， and the incidence rate was 3.5%， 7 cases with acute renal insufficiency， and the incidence rate was 1.1%， 4 cases with left ventricle rupture， and the incidence rate was 0.6% and no pericardial tamponade cases， and 8 death cases， including 2 cases with low cardiac output syndrome， 1 case with severe arrhythmia， 2 cases with multiple organ failure caused by the acute renal function insufficiency and 3 cases with left ventricle rupture. Conclusion The early prevention， accurate diagnosis， timely handing and careful nursing can reduce the severe complications after the cardiac valve surgery， which is the key to improve the success rate of operation. 　　[Key words] Cardiac valve； Complication； Prevention； Nursing 　　心?K瓣膜病是指心脏各瓣膜由于风湿热、黏液样病变、退行性改变、先天性畸形、缺血性坏死、感染或创伤等原因导致的病变，其主要表现为瓣膜的狭窄或关闭不全，可累及单个或多个瓣膜，最终导致心力衰竭和机体多脏器功能衰竭的一组疾病[1]。该类疾病病程长、病情重，患者长期受营养不良、乏力、呼吸困难等不良身体状况困扰，生活质量逐年下降。因此，越来越多的患者放弃内科的对因治疗，选择外科治疗，以达到彻底治愈的目的。但由于就诊患者存在不同程度的心脏代偿功能下降，加之手术创伤、体外循环、麻醉、术者技术等因素的影响，术后常出现严重并发症，影响手术成功率。若提高手术