杂交手术治疗合并体肺侧支的肺血减少型先天性心脏病的手术护理

Nursing Care for Hybrid Surgery to Treat Congenital Heart Disease with Diminished Pulmonary Blood Flow and Aortopulmonary Collateral Arteries

目的总结杂交手术治疗合并体肺侧支的肺血减少型先天性心脏病的手术护理要点,分享该类手术护理经验。方法对2011年5月-2012年2月开展的15例合并体肺侧支的肺血减少型先天性心脏病行一站式杂交手术的护理资料进行回顾,分析手术护理过程中出现的护理问题及应对措施和效果。结果 15例合并体肺侧支的肺血减少型先天性心脏病患者在有效的护理干预下手术顺利完成,无低心排血量综合征、灌注肺、重要脏器功能损害、神经精神障碍、全身感染等严重并发症发生,均痊愈出院。结论杂交手术治疗合并体肺侧支的肺血减少型先天性心脏病,涉及多学科协作,手术步骤复杂,术中可变因素多,手术风险大,有效的手术护理干预是保证手术顺利完成,减少并发症发生的关键因素之一。

Objective To summarize and share the surgical nursing experiences for hybrid procedures in the treatment of congenital heart disease with diminished pulmonary blood flow and aortopulmonary collateral arteries（APCA）. Methods We retrospectively analyzed the clinical data, including nursing problems, interventions and outcomes, of 15 patients with congenital heart disease with diminished pulmonary blood l ow and APCA treated between May 2011 and February 2012. Results All operations were completed successfully with ef ective nursing interventions. No complications like low cardiac output syndrome, lung over-perfusion, vital organ dysfunction, neuropsychological disorder, or systemic infection were noticed. Conclusions Hybrid procedure in the treatment of congenital heart disease with diminished pulmonary blood l ow and APCA with complex surgical procedures, intraoperative variables and high surgical risks requires multi-disciplinary collaboration. Ef ective surgical nursing intervention is important to ensure the successful completion of surgery, and reduce possible complications.