CAJ | 학술논문

目的总结二尖瓣置换术中同期行房颤射频消融术的术中护理配合方法.方法回顾性分析201 1年1—6月,118例患者在全身麻醉体外循环辅助下二尖瓣置换同期行Cox迷宫Ⅲ型房颤射频消融术患者的临床资料.结果术中体外循环时间为(118±45) min,射频消融时间为(21±7) min,心肌阻断时间为(81±35) min.术后Ⅲ度房室传导阻滞5例,均放置永久起搏器,肾衰竭1例,死亡1例.出院前Holter显示有68例(58％)患者恢复窦性心律.结论器械护士应全面了解手术过程,主动积极配合.巡回护士需准备好各种特殊仪器和设备,包括洗血球机、临时起搏器、食管超声和射频消融装置等,并熟悉使用方法和注意事项.此外,术前心理护理,术中开放足够静脉通路,摆放正确体位和压疮预防等也是护理配合的重点.
목적 총결이첨판치환술중동기행방전사빈소융술적술중호리배합방법.방법 회고성분석201 1년1—6월,118례환자재전신마취체외순배보조하이첨판치환동기행Cox미궁Ⅲ형방전사빈소융술환자적림상자료.결과 술중체외순배시간위(118±45) min,사빈소융시간위(21±7) min,심기조단시간위(81±35) min.술후Ⅲ도방실전도조체5례,균방치영구기박기,신쇠갈1례,사망1례.출원전Holter현시유68례(58％)환자회복두성심률.결론 기계호사응전면료해수술과정,주동적겁배합.순회호사수준비호각충특수의기화설비,포괄세혈구궤、림시기박기、식관초성화사빈소융장치등,병숙실사용방법화주의사항.차외,술전심리호리,술중개방족구정맥통로,파방정학체위화압창예방등야시호리배합적중점.
Objective To review the nursing cooperation methods in mitral valve replacement surgery plus concomitant atrial fibrillation radiofrequency ablation.Methods From January to June 2011,the Cox/maze Ⅲ procedure plus mitral valve replacement were performed under general anesthesia and cardiopulmonary bypass in 118 patients.Results Cardiopulmonary bypass time was (118 ± 45) minutes,radiofrequency time was (21 ± 7) minutes,cross clamp time was (81 ± 35) minutes.Five patients implanted permanent pace maker for complete atrioventricular block postoperatively,one renal failure and one death postoperative.Holter showed that 68 patients were recovery to sinus rhythm in hospital.Conclusions The instrument nurses should be familiar with the whole operative procure and cooperate effectively and actively during the operation.The circuit nurses should prepare all the special instruments including cell saver machine,temporary pace maker,transesophageal echocardiography and radiofrequency ablation machine,and understand these instruments' operating methods and cautions.Furthermore,the preoperative psychological nursing,enough venous channels,appropriate position and bedsore prevention are all the key points for nursing cooperation.