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);

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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

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