预见性护理在扩张型心肌病再同步化治疗中的应用

Effects of Forecasting Nursing on Cardiac Resynchronization Therapy in Patients with Dilated Cardiomyopathy

目的探讨扩张型心肌病并发充血性心力衰竭患者行心脏再同步化三腔起搏器植入治疗的预见性护理要点。方法对自2011年3月-2012年3月在无锡市人民医院心脏中心9例植入三腔起搏器进行心脏再同步化治疗（CRT）的扩张型心肌病患者实施预见性护理。结果9例患者均成功植入CRT起搏器，无手术相关并发症发生，术后6—12个月随访左室射血分数，左室舒张末内径、心电图QRS波形和纽约心功能分级均较术前明显改善，差异有统计学意义（P〈0．05）。结论CRT治疗是扩张型心肌病并发心力衰竭患者的有效治疗方法，而对患者实施预见性护理是取得较好治疗效果的重要保证。

Objective To explore the key points of forecasting nursing for the patients with dilated cardiomyopathy and congestive heart failure undergoing cardiac resynchronization therapy（CRT） pacemaker implantation. Methods From March 2011 to March 2012,the forecasting nursing were performed in 9 cases of dilated cardiomyopathy undergoing resynchronization therapy. The data of left ventricular ejection fraction,left ventricular end-stage dilation diameter, ECG, and NYHA function class were analyzed respectively. Results The procedures were done successfully in all patients and no complications occurred. After six to twelve months,left ventricular ejection fraction,left ventricular end-stage dilation diameter, electrocardiogram and NYHA function class were improved （P 〈 0.05）. Conclusion CRT is an effective methods in the treatment of dilated cardiomyopathy combined with congestive heart failure. The excellent forecasting nursing plays an important role in cardiac resynchronization therapy.