幼儿室间隔缺损并肺动脉高压术后并发症的预防与护理

The preventive care of complications after operation on infants with ventricular septal defect combined with pulmonary hypertension

笔者总结幼儿室间隔缺损并肺动脉高压术后并发症的预防与护理。室间隔缺损并肺动脉高压术后并发症主要在肺部,其次是心律失常和心功能衰竭;肺部并发症最严重的是肺动脉高压危象、肺不张、肺炎、急性呼吸窘迫综合征。预防与护理措施:术前1周加强营养支持,低流量吸氧、肺部理疗或给药物改善心肺功能;术后动态监测肺动脉压、SpO2,充分供氧,预防缺氧及高碳酸血症,护理操作减少对病人的刺激,以免引起烦躁或抽搐,给予镇痛镇静。合理、准确应用血管活性药物。认为加强幼儿室间隔缺损并肺动脉高压术后并发症的预防与护理,可避免或及时发现、纠正肺动脉高压危象、低心排血量综合征、心律失常及肺不张等并发症的发生。

The author in the paper summarized the preventive nursing care of infants with ventricular septal defect （VSD） combined with pulmonary hypertension （PH）. It was argued that postoperative complication mainly occurred in the lung such as pulmonary hypertension crisis, atelectasis, pneumonia, and acute respiratory distress syndrome, followed by cardiac arrhythmia and failure. The preventive nursing measures included enhanced nutrition support, oxygen inhalation at low flow, pulmonary physiotherapy or medicine administration to improve cardiorespiratory function one week before operation and postoperative dynamic monitoring of pulmonary artery pressure, SpO2, abundant supply of oxygen, prevention of hypoxia and hypercapnia, reduction of stimulus by nursing care to avoid agitation and tic, sedation by administration of sedative and at last reasonable and accurate use of active drugs. She held in belief that enhancing preventive nursing could avoid or treat in time such complications as pulmonary hypertension crisis, atelectasis, cardiac rhythm disorder and acute respiratory distress syndrome.