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。
Transcatheter aortic valve replacement (TAVR) can effectively treat symptomatic severe aortic valve stenosis, and its applicable population is gradually expanding. The perioperative and rehabilitation care of TAVR is an important influencing factor for the success of the surgery. The release of the Chinese Expert Consensus on Perioperative Nursing of Transcatheter Aortic Valve Replacement has promoted the homogenization and high-quality care of TAVR patients in China. In order to better understand the key issues of TAVR perioperative nursing and serve clinical practice, this article provides a detailed interpretation of the above consensus based on five key issues of preoperative nursing, intraoperative monitoring, postoperative intensive care nursing, ward nursing, and nutritional assessment.
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。
Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.