经导管主动脉瓣置换术治疗重度高危主动脉瓣狭窄患者的术后护理

Postoperative nursing of patients with severe and high-risk aortic stenosis treated with transcatheter aortic valve replacement

目的探讨经导管主动脉瓣置换术治疗重度高危主动脉瓣狭窄患者的术后护理。方法选择2017年4月至2018年4月在我院进行TAVI治疗的重度高危主动脉瓣狭窄患者8例为研究对象,在TAVI术完成后,对患者进行术后护理,并对护理效果进行评估,统计手术不良事件发生率、比较患者术前及术后不同时间的超声参数。结果患者围术期出现不同程度的不良情况,未出现脑卒中、死亡、外周血管大出血等其他并发症;手术后Vmax、maxPG、meanPG较手术前有明显降低,差异有统计学意义(P<0.05),LVEF较手术前有显著提高,差异有统计学意义(P<0.05);LVDD较手术前无明显变化,差异无统计学意义(P>0.05);患者术后采用护理干预具有较高的依从性,8例患者中7例患者依从性较好,依从率为87.50%。结论加强经导管主动脉瓣置换术治疗重度高危主动脉瓣狭窄患者的护理,有助于提高患者的依从性,减少了各种并发生的发生比率,提高了预后效果,值得推广应用。

Objective To investigate the postoperative nursing of patients with severe and high-risk aortic stenosis treated with transcatheter aortic valve replacement.Methods A total of 8 patients with severe and high-risk aortic stenosis admitted to our hospital and treated with TAVI from April 2017 to April 2018 were selected as the research objects.After the TAVI operation was completed,the patients were given postoperative nursing,and the nursing efficacies were evaluated.The incidences of adverse events were counted,and the ultrasound parameters of patients at different times before and after operation were compared.Results There were different degrees of adverse events during perioperative period,but there were no other complications such as stroke,death and massive hemorrhage of peripheral blood vessels.Compared with that before operation,Vmax,maxPG,meanPG were decreased significantly,with statistically significant differences(P<0.05),while LVEF was increased significantly,with statistically significant difference(P<0.05).There was no significant change in LVDD compared with that before operation,without statistically significant difference(P>0.05).The patients′compliance of postoperative nursing intervention was relatively high,and 7 out of 8 patients had better compliance of 87.50%.Conclusion Strengthening nursing care of patients with severe and high-risk aortic stenosis treated with transcatheter aortic valve replacement is helpful to improve the compliance of patients,reduce the incidence of various complications and improve the prognosis efficacy,which is worthy of promotion and application.