经心尖行二尖瓣修复患者围手术期加速康复的护理实践

Nursing practice of perioperative enhanced rehabili tation of patients undergoing transapical mitral valve repairment

总结1例重度二尖瓣脱垂患者经心尖行二尖瓣缘对缘联合腱索修复围手术期加速康复的护理经验。护理重点:结合患者病情和手术方式选择床单位,针对性调整切口、引流管、液体管理方案;以加速康复指南为指导,多学科共同参与,制订术前等待期、重症期、稳定期和离院前期的运动康复方案,阶梯式呼吸、营养支持、健康教育和心理护理贯穿于加速康复的全过程。本例患者术后心力衰竭症状明显改善,心功能恢复到Ⅰ级,无严重并发症,术后5 d康复出院,随访1个月恢复良好。

To summarize the nursing practice of perioperative enhanced rehabilitation in a patient with severe mitral valve prolapse undergoing transapical mitral valve edge-to-edge combined with chordae repairment.Nursing focus:Choosing the bed unit based on the patient’s condition and the operation method;Targeted adjustment of incision,drainage tube and fluid management plan;Guided by accelerated rehabilitation guidelines,multidisciplinary participation to formulate the preoperative waiting period,severe illness period,stable period and pre-discharge period stepped breathing,exercise rehabilitation program,nutritional support,health education and psychological care through the whole process of accelerating recovery.The patient’s heart failure symptoms were improved significantly after surgery.Heart function returned to gradeⅠwith no serious complications.He was discharged 5 days after the operation,and recovered well after 1 month follow-up.