高危患者在心室辅助下行冠状动脉介入治疗的围术期护理

Perioperative nursing care of coronary artery interventional treatment supported by ventricular assist device in high-risk patients

目的探讨高危患者在心室辅助装置支持下经皮行冠状动脉介入治疗的围术期护理方法。方法回顾性总结分析2例高危冠心病并发心力衰竭患者在心室辅助支持下经皮行冠状动脉介入治疗的围术期护理实践。结果 2例患者在心室辅助支持下先后接受经皮冠状动脉介入治疗,经过术前心理护理,采取措施改善心功能、营养状况及其他合并疾病治疗,术前环境、设备、仪器等的充分准备,术后注重心室辅助装置的运转观察,严密心律、心率、血压等监护,发现异常及时处理,做好撤机的各项准备和配合等护理措施。2例患者均痊愈出院。结论做好围术期各项护理,可有效保证高危患者平稳接受心室辅助支持下经皮行冠状动脉介入治疗,并顺利康复。

Objective To explore the perioperative nursing care of coronary artery interventional treatment supported by ventricular assist device in high-risk patients. Methods Perioperative nursing practice of 2 cases of high-risk patients with coronary heart disease and heart failure who underwent percutaneous coronary artery intervention were analyzed retrospectively with Impella 2. 5. Results In 2 cases of patients with ventricular assist support underwent percutaneous coronary intervention,both of them got well and discharged after preoperative psychological nursing. Before the percutaneous coronary intervention（ PCI） we evaluated the psychological situation of the patients,improved the heart function,nutritional status and complication,had equipments,instruments and environment prepared and made multi-discipline emergency plan. After PCI we strictly observed the Impella,monitored the rhythm,heart rate and blood pressure and prevented the complications,such as bleeding of puncture site and hemolysis. Both of the patients got well and successfully discharged after the meticulous nursing care.Conclusion Perioperative nursing care can effectively ensure the safety of high risk patients underwent PCI with Impella 2. 5 and improve the rehabilitation.