房室结消融联合希氏束起搏术治疗持续性心房颤动伴心力衰竭患者的术后护理

Nursing of patients with persistent atrial fibrillation and heart failure treated with atrioventricular node ablation combined with His bundle pacing

目的总结房室结消融联合希氏束起搏术治疗持续性心房颤动伴心力衰竭患者术后的有效护理措施。方法选取2018年1月~2019年6月在我院心内科成功行房室结消融联合希氏束起搏术治疗的持续性心房颤动伴心力衰竭患者44例进行术后护理干预,包括进行严密的心电监护、术后并发症观察、康复指导等,出院后门诊随访至少6个月。结果44例患者术后有2例出现起搏器囊袋出血,予以延长沙袋压迫后无出血现象。出院6个月后随访成功者为40例,患者术后左室射血分数(LVEF)为(44.2±13.0)%,明显高于术前的(34.5±9.0)%,差异有统计学意义(P<0.01);术后左室舒张末期容积(LVEDV)为(134.8±55.9)mL,低于术前的(162.5±57.9)mL,差异有统计学意义(P<0.05)。结论通过对房室结消融联合希氏束起搏术后的患者开展针对性护理,可减少术后并发症,有利于患者术后恢复,改善患者心功能,提高患者生命质量。

Objective To summarize the effective nursing measures in patients with persistent atrial fibrillation and heart failure treated with atrioventricular node ablation combined with His bundle pacing.Methods A total of 44 patients with persistent atrial fibrillation and heart failure who successfully treated with atrioventricular node ablation combined with His bundle pacing in the cardiology department of our hospital from January 2018 to June 2019 were intervened with postoperative nursing intervention,including strict ECG monitoring,observation of postoperative complications,and rehabilitation guidance.The outpatient follow-up lasted for at least six months after discharge.Results Two of the 44 patients had pacemaker pocket bleeding after surgery.And there was no bleeding after prolonged sandbag compression.Six months after discharge,40 patients were followed up successfully.The postoperative left ventricular ejection fraction(LVEF)was(44.2±13.0)%,which was significantly higher than that(34.5±9.0)%before surgery(P<0.01).The ventricular end-diastolic volume(LVEDV)after surgery was(134.8±55.9)mL,which was lower than that(162.5±57.9)mL before surgery(P<0.05).Conclusion The targeted nursing of patients after atrioventricular node ablation combined with His bundle pacing can reduce postoperative complications,help patients recover after surgery,improve patients'cardiac function,and improve their quality of life.