镶嵌治疗小儿室间隔缺损的护理

Nursing of Hybrid Therapy for Ventricular Septal Defect in Children

目的:探讨镶嵌治疗小儿室间隔缺损的护理实践。方法:自2006年1月～2008年9月,在经食管超声心动图(TEE)的辅助下,采用镶嵌手术治疗室间隔缺损24例,其中15例患儿经右室表面穿刺置入封堵器,5例在CPB(体外循环)下直视置入封堵器,4例在CPB下置入封堵器后同期手术矫治其他畸形的术前护理及术后护理(术后一般护理,术后并发症的预防护理,出院指导)。结果:24例室间隔缺损镶嵌治疗后做好针对护理,减少并发症,缩短术后恢复期,均获得满意疗效。讨论:将心脏外科和内科介入结合的镶嵌治疗,是小儿先天性心脏病的新型治疗模式,对于护理的适应与配套也提出了相应的要求。随着镶嵌技术的进一步发展与应用,护理将面临新的挑战。

Objective： To review the nursing experience of intraoperative hybrid therapy for ventricular septal defect in children. Methods： From Jan 2006 to Sep 2008, 24 children with ventricular septal defect underwent hybrid therapy under transesophageal echocardiographic guidance. Of them, the occluder was introduced through right ventricular surface in 15 cases, 5 cases under cardiopulmonary bypass to close muscular ventricular septal defects, and another 4 cases were performed other cardiac operations during the occludeing. The postoperative nursing, complications preventing and outpatient directions were summarized. Results： With a proper nursing program, the ,94 children who received the hybrid technique were recovered uneventfully. Conclusion： The hybrid therapy with combined surgical technique and interventional procedure for closure of ventricular septal defect might be a new and effective method in children and a new challenge should be presented before the clinical nurse.