个体化精细干预对行射频消融全麻术房颤患者心功能的影响

Effect of individualized meticulous interventions on cardiac function of patients with atrial fibrillation undergoing radiofrequency ablation under general anesthesia

目的 研究个体化精细干预对行射频消融全麻术房颤患者的临床效果及对心功能的影响。方法 纳入2019年1月至2020年12月收治的86例行射频消融全麻术房颤患者作为研究对象,2019年1~12月收治的43例设为对照组,给予常规护理;2020年1月~12月收治的43例设为观察组,在常规护理基础上给予个体化精细干预;观察2组患者围手术期指标和术后第1、3、14天心功能指标[左心房内径(LAD)、左心室射血分数(LVEF)、左心室重量指数(LVMI)]及术后48 h心理应激指标[心率(HR)、平均动脉压(MAP)],同时对2组围手术期并发症发生情况进行对比分析。结果 观察组麻醉苏醒时间、术后首次下床活动时间、首次排气时间、首次排便时间和住院时间均短于对照组(P<0.05);术后第14天观察组LAD和LVMI低于对照组(P<0.05),LVEF高于对照组,组间差异均有统计学意义(P<0.05);观察组术后48 h HR、MAP均低于对照组(P<0.05);观察组围手术期并发症总发生率低于低于对照组(P<0.05)。结论 对行射频消融全麻术房颤患者实施个体化精细干预的效果良好,可促进患者术后恢复,稳定术后心功能指标,减少心理应激反应和围手术期并发症的发生,提高临床治疗有效性和安全性。

Objective To analyzed the effect of individualized meticulous interventions and its effect on cardiac function in patients with atrial fibrillation undergoing radiofrequency ablation under general anesthesia.Methods From January 2019 to December 2020,86 patients with atrial fibrillation undergoing radiofrequency ablation under general anesthesia admitted were enrolled,in which 43 cases(from January 2019 to December 2019)were received routine nursing care(control group)and 43 cases(from January 2019 to December 2019)were received individualized meticulous interventions+routine nursing care(observation group),respectively.The perioperative indicators,cardiac function indicators(left atrial diameter[LAD],left ventricular ejection fraction[LVEF],left heart to mass index[LVMI])at 1,3 and 14 days after surgery,psychological stress indicators(heart rate[HR],mean arterial pressure[MAP])at 48 h after surgery and the incidence of perioperative complications in the two groups were compared.Results The time to wake up from anesthesia,first time of out-of-bed activities,first time to exhaust gas,first time to defecate and length of stay in the observation group were significantly shorter than those in control group(P<0.05).LAD and LVMI at 14 days postoperatively were significantly lower in the observation group than those in the control group(P<0.05),while LVEF was significantly higher(P<0.05).HR and MAP at 48 h postoperative were significantly lower in the observation group than those of control group(P<0.05).The total incidence of perioperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Individualized meticulous interventions are effective to patients with atrial fibrillation undergoing radiofrequency ablation under general anesthesia,which can promote postoperative recovery,stabilize postoperative cardiac function indicators,reduce psychological stress response and perioperative complications,with a high safety.