240例心房颤动射频消融术患者的围术期护理

Perioperative nursing care of 240 patients with atrial fibrillation undergoing radiofrequency ablation

【目的】总结经皮导管射频消融术围手术期的护理经验。【方法】回顾性分析于我院初次行经皮导管射频消融术的240例患者的围术期护理情况,总结围手术期护理经验。【结果】240例房颤患者均顺利完成经皮导管射频消融术,22例患者术后出现快速型心律失常,其中再发阵发性房颤15例,房扑6例,房速1例。予胺碘酮或普罗帕酮静脉滴注后,19例患者心律住院期间心律转复并维持窦性心律,2例患者行床边电复律后转复窦性心律。另有18例患者出现房性早搏,予普罗帕酮口服后早搏消失或明显减少。3例患者发生穿刺部位血肿,1例患者发生穿刺部位动静脉瘘,予局部压迫及弹力绷带加压包扎后均痊愈,无其余并发症发生。【结论】在经皮导管射频消融术围手术期间,良好的护理可降低手术并发症发生风险,为降低术后并发症和提高手术成功率提供了有力保障。

【Objective】To summarize the perioperative nursing experience of percutaneous catheter radiofrequency ablation.【Methods】The perioperative nursing of 240 patients who underwent percutaneous catheter radiofrequency ablation for the first time in our hospital was analyzed retrospectively,and the perioperative nursing experience was summarized.【Results】240 patients with atrial fibrillation successfully completed percutaneous catheter radiofrequency ablation.22 patients developed tachyarrhythmia,including 15 cases of recurrent paroxysmal atrial fibrillation,6 cases of atrial flutter and 1 case of atrial tachycardia.After intravenous infusion of amiodarone or propafenone,19 patients recovered and maintained sinus rhythm during hospitalization,and 2 patients recovered sinus rhythm after bedside electrical cardioversion.Another 18 patients had atrial premature beats,which disappeared or significantly decreased after oral administration of propafenone.Hematoma at the puncture site occurred in 3 patients and arteriovenous fistula at the puncture site occurred in 1 patient.All patients were cured after local compression and elastic bandage compression and bandage.There were no other complications.【Conclusion】During the perioperative period of percutaneous catheter radiofrequency ablation,good nursing can reduce the risk of surgical complications,and provide a strong guarantee for reducing postoperative complications and improving the success rate of surgery.