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经导管三尖瓣缘对缘修复术患者的手术护理

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总结25例经导管三尖瓣缘对缘修复患者的手术护理经验.护理重点包括术前对高风险患者做好差异化应急准备,完善三尖瓣夹合器和手术仪器准备;术中针对三尖瓣反流疾病特征安置舒适体位,调试操作系统避免血栓及空气栓塞,警惕患者肝素化过程中的出血,积极预防术中恶性心律失常,实施目标导向性的血糖护理干预;术后转运避免夹合器脱落等.患者手术顺利,术后即刻反流由重度及以上下降至轻度13例,下降至中度10例,2例反流等级分别从5级和4级下降为3级;术后3～7 d出院.术后随访6个月,25例患者反流等级均在3级及以下,心功能和生活质量均有显著改善.
Intraoperative care of patients undergoing transcatheter edge-to-edge valve repair for tricuspid regurgitation
A total of 25 patients underwent transcatheter edge-to-edge valve repair for tricuspid regurgitation.The experiences of ca-ring for these patients during the operation were summarized,including making preparedness plans for emergency situations for high-risk patients;preparing surgical instruments and clips for valve repair;placing patient at comfortable position based on the characteristics of tricuspid regurgitation;adjusting the operating system to avoid thrombosis and air embolism;monitoring blee-ding complications during heparinization;preventing malignant arrhythmias;implementing goal-directed glycemic control;and preventing clamp dislodgement.Immediately after the operation,the regurgitation grade was decreased,from severe or very severe(grade≥3),to mild(grade 1)in 13 patients,to moderate(grade 2)in 10 patients,and to grade 3 in 2 patients.All patients were discharged in 3 to 7 days after the surgery,and followed-up for 6months.Regurgitation grade was≤3,cardiac function and quality of life were significantly improved.

tricuspid regurgitationtranscatheter tricuspid edge-to-edge valve repairinterventional surgeryemergency pre-parednessglycemic controlthrombosisair embolismintraoperative nursing care

王雅琳、陈丽莉、钱吉利、孙新星

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浙江大学医学院附属第一医院手术室(浙江杭州,311200)

温州医科大学附属第一医院护理部

三尖瓣反流 经导管三尖瓣缘对缘修复术 介入手术 应急准备 血糖管理 血栓 空气栓塞 手术室护理

浙江省科技计划项目浙江省教育厅一般科研项目(自然科学类)

2023C03087Y202353856

2024

10.3870/j.issn.1001-4152.2024.17.055

护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCD北大核心
影响因子：2.062
ISSN：1001-4152
年,卷(期)：2024.39(17)