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弹力绷带“8”字包扎法对经皮穿刺股动脉行心脏介入诊疗后伤口出血或血肿发生率的影响

【摘要】　目的　研究弹力绷带“8”字包扎法对经皮穿刺股动脉行心脏介入诊疗后伤口出血或血肿发生率的影响。　方法　2010年 1-6月收治的600例经皮穿刺股动脉行心脏介入诊疗后患者，随机分为对照组（300例）和试验组（300例），两组在年龄、性别、病理、心功能、有无高血压、器质性心脏病、术中肝素使用量、术后人工压迫止血时间、下床活动时间等差异均无统计学意义（Pgt;0.05），术后72 h观察出血或血肿发生情况。　结果　对照组出血或血肿发生率9/300（3%），试验组出血/血肿发生率2/300（0.67%），两组差异有统计学意义（P=0.033）。　结论　对经皮穿刺股动脉行心脏介入诊疗后，用弹力绷带“8”字包扎法包扎伤口能降低血肿的发生率。

健康教育在冠状动脉64层CT检查病人中的价值

Nursing Care in Radiofrequency Catheter Ablation for Idiopathic Ventricular Tachycardia under the Guidance of Three-dimensional Mapping System

目的　总结在三维标测系统Carto 3指导下射频消融治疗特发性室速患者的护理方法。 方法　对2010年11月－2011年10月收治的62例特发性室速患者，采用Carto 3系统进行心室标测和消融治疗，并予以周全细致的护理。 结果　本组61例患者顺利完成射频消融术，1例因诱发室颤后停止手术。术后随访6个月，3例出现既往相同形态室速，其余58例症状较前均有不同程度的缓解，未发生明显心动过速，手术成功率为93.55%。 结论　Carto 3系统指导下的特发性室速射频治疗安全、高效，可减少射线透视量，恰当细致的护理配合是手术获得成功的基础与保障。

心理干预在持续性心房颤动患者射频消融治疗中的应用效果

目的讨论系统性心理护理干预在经导管射频消融治疗持续性心房颤动（房颤）患者的临床应用效果。 方法将2012年3月－2013年4月行房颤射频消融术治疗的持续性房颤患者80例，随机分为对照组（40例）和干预组（40例），两组患者在常规治疗与护理基础上，干预组患者同时强化心理干预。并应用焦虑自评量表（SAS）和抑郁自评量表（SDS），对两组患者的治疗效果及SAS、SDS评分进行评价。 结果两组患者在平均住院时间、手术成功率和患者满意度调查方面，干预组明显优于对照组，干预后干预组患者SAS与SDS评分明显低于对照组，差异有统计学意义（P＜0.05）。 结论心理护理干预能够改善房颤患者负面情绪，提高射频消融治疗效果。

心脏再同步化治疗植入术中的观察及护理

目的探讨心脏再同步化治疗（CRT）术中的观察及护理，为手术成功提供保障。 方法2011年1月－12月对80例实施CRT的慢性心力衰竭患者进行精心的术前准备，术中配合及护理。 结果79例患者顺利成功植入CRT，参数良好，效果满意。1例患者因冠状静脉弯曲、严重钙化、狭窄，左室电极未成功置入，安置成双腔起搏器。 结论术前的充分准备，术中良好的配合是取得手术成功的保障，可减少并发症的发生，提高患者的生活质量。

Efficacy of Dezocine for Atrial Fibrillation Radiofrequency Catheter Ablation

ObjectiveTo observe the efficacy of dezocine used for atrial fibrillation radiofrequency catheter ablation. MethodsForty-five patients who would undergo radiofrequency catheter ablation of atrial fibrillation were randomly chosen to be our study subjects between April and July 2013. According to the randomized and double-blind principle, they were divided into group D (dezocine group) and group M (morphine group). During routine visits prior to surgery, we recorded the patients' vital signs, pain score and degree of comfort. Before the ablation procedure, 5 mg dezocine or 5 mg morphine was administered intravenously for patients in both the two groups. During the procedure, blood pressure, heart rate, oxygen saturation, electrocardiogram, pain scores, and comfort score of the patients were monitored. Furthermore, 2-3 mg dezocine or morphine were administered intravenously if additional analgesia was needed. The time of the procedure was recorded. The patients were followed up and evaluated 2, 6 h and 24 hours after the procedure. ResultsThe procedure time, pain rating index, and visual analogue scores were significantly different between the two groups (P < 0.05). Adverse reaction during or after the procedure was not significantly different (P > 0.05). ConclusionsThe analgesic effect of dezocine is better than morphine for atrial fibrillation radiofrequency catheter ablation. The incidence of adverse reactions such as nausea and vomiting is still high. Dezocine for analgesia in atrial fibrillation ablation can be used as an ideal alternative instead of general anesthesia.

经房间隔经导管二尖瓣置换术的手术配合及护理三例

经皮经肝静脉植入心律转复除颤器一例的术中护理策略

Comparative Study of the Effects between Innovative and Conventional Approach of Follow-up after Permanent Pacemaker Implantation

ObjectiveTo explore the efficacy of an innovative approach of follow-up in patients implanted with permanent pacemaker (DDD). MethodsA total of 400 patients who underwent permanent pacemaker (DDD) implantation between June 2011 and June 2013 were included in the present study. Patients were randomly assigned to the innovative and conventional follow-up groups in a 1：1 manner (200 patients in each group). The baseline characteristics were well balanced with no statistically significant differences in the mean age, proportion of male sex, prevalence of hypertension, position of the electrode or the device used between the two groups. At the end of the follow-up, patient outcomes were compared between the two groups. ResultsThe outcomes of patients were better in the innovative follow-up group, with higher degree of satisfaction, better state of health, lower incidence of complications, and less frequent readmission and follow-up visits (all P<0.05). ConclusionThe innovative approach of follow-up considerably improves patient outcomes, and can be useful in future clinical practice.

Nursing Experiences for Patients Undergoing Transcatheter Aortic Valve Implantation

目的　分析总结经导管主动脉瓣置入的术中护理要点，以指导临床术中护理。 方法　回顾性分析2012年4月－5月新开展经股动脉逆行法经导管主动脉瓣置入术3例患者的临床资料。术前备齐手术用物及急救药品、术中协助患者正确体位，准确使用临时起搏器、除颤仪、认真做好病情及并发症观察和护理，总结术中临床护理方法。 结果　经导管主动脉瓣置入手术顺利成功，术中护理效果满意，无因物品或药品准备不齐及护理不当而影响手术进程、造成患者意外损伤及并发症发生。 结论　经导管主动脉瓣置入术，术前备齐相应的导管导丝，术中操作规范细致、及时、准确传递用物、认真进行临床观察和护理，手术顺利、成功无不良事件发生及并发症发生。