瓣膜置换术后早期并发恶性心律失常致患者心脏骤停

皮静虹; 陈文敏; 贾政; 那竹惠; 杨佳; 付琼芬

瓣膜置换术后早期并发恶性心律失常致患者心脏骤停

昆明医科大学附属延安医院昆明延安医院心脏大血管外科ICU

基金项目:

基金：昆明市延安医院院内科研基金资助项目 (YYKY014-036);

计量
- 文章访问数: 1893
- HTML全文浏览量: 647
- PDF下载量: 60
- 被引次数: 0
出版历程
- 收稿日期: 2017-04-13

Cardiac Arrest Caused by Malignant Arrhythmia in Patients in Early Stage after Valve Replacement

Funds:

基金：昆明市延安医院院内科研基金资助项目 (YYKY014-036);

摘要

摘要: 目的探讨瓣膜置换术后早期并发恶性心律失常致患者心脏骤停急救过程中的相关问题, 为临床提供参考.方法将昆明延安医院心脏大血管外科2013年1月至2015年1月心脏瓣膜置换术后早期并发恶性心律失常致患者心脏骤停的35例患者, 设为A组, 2015年2月至2017年2月心脏瓣膜置换术后早期并发恶性心律失常致患者心脏骤停的35例患者, 设为B组.研究中, 对A组的抢救措施及护理进行回顾性详细分析、认真分析护理措施, 全面总结临床经验和缺点, 对恶性心律失常而引起心脏骤停患者的护理流程、质量标准和专业培训进行重新分析, 制定出标准、规范、科学、有效的管理制度, 并将其应用于B组.分析比较2组患者窦性心律恢复时间、自主血压恢复时间、自主呼吸恢复时间、抢救患者成功的例数、胸外心脏按压时间、电击除颤次数、使用抗心律失常药物的种类、床旁开胸例数、使用临时起搏器例数、呼吸机辅助时间及预后情况.结果 B组窦性心律恢复时间、自主血压恢复时间、自主呼吸恢复时间、胸外心脏按压时间、呼吸机辅助时间均低于A组;B组的抢救初步成功率、抢救完全成功率均高于A组, 差异具有统计学意义 (P
- 瓣膜置换术后 /
- 恶性心律失常 /
- 心脏骤停 /
- 护理
Abstract: Objective To investigate the related problems in the emergency treatment of cardiac arrest in patients with early cardiac arrhythmias after valve replacement, and to provide reference for clinical practice.Methods 35 cases of cardiac arrest induced by early malignant ventricular arrhythmia after heart valve replacement in our department from January 2013 to January 2015 were selected as A group, 35 cases of cardiac arrest induced by early malignant ventricular arrhythmia after heart valve replacement in February 2015 to February 2017 were selected as the B group. In the study, treatment and nursing data of patients in A group were retrospectively analyzed, the nursing measures were carefully analyzed, and the clinical experience and shortcomings were summarized, the nursing process, quality standard and professional training for the cardiac arrest patients induced by malignant arrhythmia were reanalyzed, and formulated a standard, normal, scientific and effective management system. Then we applied the new management system in B group. We compared the sinus rhythm recovery time, the autonomous blood pressure recovery time, the autonomous breathing recovery time, the cases of successful rescue, the chest compression time, the defibrillation frequency, the types of used antiarrhythmic drug, the cases of bedside thoracotomy, the cases of using temporary pacemaker, the mechanical ventilation time and the prognosis of the patients. Results The sinus rhythm recovery time, the autonomous blood pressure recovery time, the autonomous breathing recovery time, the chest compression time, and the mechanical ventilation time of patients in B group were lower than the A group, the preliminary rescue success rate, the success rate of rescue in B group were higher than the A group, the difference was statistically significant (P < 0.05) . Conclusions For early rescue of cardiac arrest caused by malignant arrhythmia after valve replacement, the key is to strengthen the observation, early detect, give timely defibrillation, regulate the use of intravenous catheters and temporary pacemaker antiarrhythmic drugs and pay attention to use the central venous catheter and the temporary pacemaker.
- After valve replacement /
- Malignant arrhythmia /
- Cardiac arrest /
- Nursing

HTML全文

参考文献(15)

[1]左婷婷, 叶李莎, 凌华.心脏瓣膜替换术后并发恶性心律失常的护理[J].实用临床医学, 20113, 12 (7) :117.
[2]	[2]LECLEREQ T, PARREL S, MIERDL S, et al.Acquired long QT syndrome and cardiac arrest after general anesthesia.Case report and review of literature[J].Ann Fr Anesth Reanim, 2014, 33 (6) :421.
[3]徐琼英.恶性心律失常致心脏骤停患者的护理干预[J].护士进修杂志, 2014, 29 (3) :244.
[4]	[4]COYAL D, NADAR SK, WRIGLEY B, et al.Successful use of intra-aortic counter pulsation therapy for intractable ventricular arrthythmia in patient with severe left ventricular dysfunction and normal coronary arteies[J].Cardiol J, 2010, 17 (4) :401-403.
[5]欧阳兆忠, 吴木富.恶性心律失常42例急救的临床分析[J].中国实用医药, 2012, 7 (21) :57.
[6]刘大为.实用重症医学[M].北京:人民卫生出版社, 2010:444.
[7]周利, 张婷, 刘思.护理干预用于恶性心律失常致心脏骤停患者中的效果评价[J].实用临床医药杂志, 2016, 20 (20) :3.
[8]蒋丽虹, 邹弘麟, 李亚雄.心脏外科围术期管理实用手册[M].北京:中国科学技术出版社, 2016:182.
[9]白冰冰, 石丽, 贾艳, 等.心血管病护理手册[M].北京:中国协和医科大学出版社, 2007:25.
[10]石丽.实用心胸血管外科护理及技术[M].北京:科学出版社, 2008:69.
[11]王欣然, 杨莘.危重病护理临床思维[M].北京:科学技术文献出版社, 2010:88.
[12]李宏伟, 张艳芹, 陈涛, 等.前位护理路径在预防急性心肌梗死并发恶性心律失常的效果评价[J].山西医药杂志, 2014, 43 (6) :701-703.
[13]林金金.恶性心律失常预见性护理分析[J].现代诊断与治疗, 2015, 26 (9) :2146-2147.
[14]	[14]HERSI A S, ALHABIB K F, AIFALEH H F, et a1.Incidence of ventricular arrhythmia and associated patient outcomes in hospi-t Mized acute coronary syndrome patients in saudi arabia:find-ings from the registry of the saudi project for assessment of acute coronary syndrome (SPACE) [J].Ann Saudi Med, 2012, 32 (4) :372-377.
[15]李小勤, 童本沁, 杨惠花, 等.恶性心律失常的早期识别与急救护理[J].江苏医药, 2013, 39 (23) :2942-2943.

相关文章(20)

[1]	杨晓露, 王淑娟, 白向峰. 以家庭为中心的护理对心脏瓣膜置换术后患者生存质量的影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210831
[2]	胡凤婵. 共情护理对剖宫产产妇焦虑情绪及护理满意度的影响, 昆明医科大学学报.
[3]	郑艳. 全程健康教育护理模式在内分泌科糖尿病护理工作中的应用, 昆明医科大学学报.
[4]	马燕丽. 艾灸在病毒性肝炎治疗中的应用及护理, 昆明医科大学学报.
[5]	罗丽云. 20例外科手术后患者术后并发压疮的护理体会, 昆明医科大学学报.
[6]	陈晓娜. 床旁临时心脏起搏器置入术围手术期的护理体会, 昆明医科大学学报.
[7]	杨秀华. 经鼻蝶窦行垂体腺瘤切除术后的护理, 昆明医科大学学报.
[8]	解燕华. CIK细胞治疗恶性肿瘤患者的护理体会, 昆明医科大学学报.
[9]	李秀芬. 老年患者全身麻醉术后苏醒延迟的护理, 昆明医科大学学报.
[10]	冯睿. 膝关节置换术后广泛性张力性水疱患者的护理体会, 昆明医科大学学报.
[11]	朱丽仙. 无痛分娩360例临床观察及护理, 昆明医科大学学报.
[12]	秦惠芝. 低体重先心病心内直视术的护理体会, 昆明医科大学学报.
[13]	李瑞. CIK细胞治疗泌尿系统恶性肿瘤的护理体会, 昆明医科大学学报.
[14]	陈文敏. 小儿先天性心脏病术后早期行腹膜透析治疗的临床观察及护理, 昆明医科大学学报.
[15]	陈文敏. 体外循环术后延迟关胸患者的护理体会, 昆明医科大学学报.
[16]	赵雷. 肝移植术后患者低体温的护理体会, 昆明医科大学学报.
[17]	. 小儿隐睾睾丸下降固定术治疗46例护理体会, 昆明医科大学学报.
[18]	. 颅内动脉瘤显微手术围手术期护理, 昆明医科大学学报.
[19]	. 人工鼻泪道支架植入术治疗慢性泪囊炎的护理, 昆明医科大学学报.
[20]	吉建华. 46例老年股骨颈骨折患者的术前术后护理体会, 昆明医科大学学报.