小儿法洛四联症根治术围手术期的护理

Attendant experience of young children with tetralogy of Fallot during peri-operative complete correction

目的总结78例小儿法洛四联症根治术,患儿围手术期的临床护理经验。方法术前做好健康教育及心理护理,给予患儿镇静、吸氧,防止缺氧发作。术后密切观察病情,加强呼吸、循环监护,预防肺不张和肺部感染,防止低心输出量等并发症,做好出院健康指导。结果治愈出院69例,术后早期因低心输出量综合征死亡7例,多器官功能衰竭死亡2例。结论小儿法洛四联症是心脏并存多种畸形,手术危险性大,术后的并发症和病死率较高,围手术期护理非常重要,是保证手术成功、术后恢复的重要环节。

Objective To summarize the clinical attendant experience during pre- and post- operation on 78 cases of pediatric tetralogy of Fallot radical treatment. Methods Took the appropriate health education and psychologic attendance pre-operation, provided sedative, oxygen and prevented anoxia;extensive cared the patient post-operation,strengthened the observation of breath and circulation,prevented the complications of atelectasis,pneumonia and low cordiac output syndrome, and provided correct discharge health instruction. Results Sixty-nine cases were discharged with complete cure,7 cases died with low cardiac output syndrome in early stage,2 cases died with multiple organ failure syndrome. Conclusions Pediatric tetralogy of Fallot is a multiple cardiamorphia with high surgical risk, post-operative complications and case-fatality ratio. The pre- and post- operative attendances are definitely crucial and have become an important successful guarantee of operation and recover,