主动电极导线植入在患儿右室间隔部起搏中的应用及护理

Application of active electrodes in pediatric patients with right ventricular septal cardiac pacing and the nursing strategy

目的探讨主动电极导线的植入在患儿右室间隔部起搏中的应用方法及护理经验。方法对20例Ⅲ度房室传导阻滞患儿采用Medtronic起搏器植入心室主动电极导线,并做好术前准备,术后严密观察病情,及时发现和处理并发症等护理。结果主动电极导线成功植入右室间隔18例;另2例电极定位间隔部失败,改行常规心尖部起博。6例出现并发症,经及时处理好转。全部患儿阈值无改变,起搏功能正常。结论指导患儿做好自我管理对有效控制危险因素具有重要的意义;做好术前准备,术后严密观察病情,及时发现和处理并发症对手术的成功具有积极的意义。

Objective To explore the application of active electrodes in pediatric patients with right ventricular septal cardiac pacing and the nursing strategies. Methods 20 children with phase Ⅲ atrial ventricular block received implantation of active electrodes of Medtronic pacemaker. The corresponding nursing care was conduced like careful preoperative preparation, intensive electrocardio monitoring and timely treatment of postoperative complications. Results The implantations of the active electrodes were successful in 18 cases but they failed in 2, turning to routine pacemaking at heart apex. Complications happened to 6, but recovered after timely treatment. Among them, all of 6 cases with complication had been successfully cured after reoperation. Conclusions The control of risk factors is key to the implantation of pacemakers for children patients. Preoperative careful preparation, close monitoring during operation, postoperative close observation, and timely treatment of complications all contribute to the success of implantation