1例艾森曼格综合征产妇行双肺移植同期室间隔缺损修补术后的肺康复护理

doi:10.3761/j.issn.0254-1769.2021.06.019

摘要/Abstract

摘要：

总结1例艾森曼格综合征产妇行双肺移植同期室间隔缺损修补术后的肺康复护理经验。护理要点包括：组建多学科肺康复团队、进行序贯式呼吸支持治疗与护理、正确使用呼吸功能训练器、循序渐进地进行运动功能康复锻炼、加强营养支持及心理康复。经过多学科团队合作,患者术后第1天拔除气管插管并下床活动,术后第46天顺利出院。

关键词: 艾森曼格综合征, 妊娠, 肺移植, 室间隔缺损, 围手术期护理

Abstract:

To summarize the lung rehabilitation nursing experience of a case of Eisenmenger syndrome after double lung transplantation and ventricular septal defect repair. The key points of nursing include：establishing multi-disciplinary pulmonary rehabilitation team,carrying out sequential respiratory support treatment and nursing,using respiratory function training apparatus correctly,carrying out motor function rehabilitation exercise step by step,and strengthening nutritional support and psychological rehabilitation. After multidisciplinary team cooperation,the patient was extubated on the first day after surgery and got out of bed,and discharged smoothly on the 46th day after operation.

Key words: Eisenmenger Syndrome, Pregnancy, Lung Transplantation, Heart Septal Defects,Ventricular, Perioperative Nursing

卢山,苏云艳,孙小玲,王哲芸. 1例艾森曼格综合征产妇行双肺移植同期室间隔缺损修补术后的肺康复护理[J]. 中华护理杂志, 2021, 56(6): 912-916.

LU Shan,SU Yunyan,SUN Xiaoling,WANG Zheyun. Nursing care of lung rehabilitation for a case of Eisenmenger syndrome parturient woman after double lung transplantation and ventricular septal defect repair[J]. Chinese Journal of Nursing, 2021, 56(6): 912-916.

参考文献 19

[1]	Lopez BM, Malhamé I, Davies LK, et al. Eisenmenger syndrome in pregnancy:a management conundrum[J]. J Cardiothorac Vasc Anesth, 2020,34(10):2813-2822. DOI URL
[2]	Dimopoulos K, Harries C, Parfitt L. The spectrum of pulmonary arterial hypertension in adults with congenital heart disease:management from a physician and nurse specialist perspective[J]. J Congenit Heart Dis, 2017,1:5. DOI URL
[3]	Goldraich LA, Stehlik J, Kucheryavaya AY, et al. Retransplant and medical therapy for cardiac allograft vasculopathy:international society for heart and lung transplantation registry analysis[J]. Am J Transplant, 2016,16(1):301-309. DOI URL
[4]	吕秀霞, 陈瑞云, 魏立, 等. 肺移植患者肺康复的研究进展[J]. 中华护理杂志, 2019,54(5):765-770.
	Lü XX, Chen RY, Wei L, et al. Research progress on pulmonary rehabilitation in patients undergoing lung transplantation[J]. Chin J Nurs, 2019,54(5):765-770.
[5]	王聪, 万群芳, 吴小玲. 1例晚期肺纤维化老年患者肺移植术后早期运动的护理[J]. 中华护理杂志, 2017,52(8):1015-1017.
	Wang C, Wan QF, Wu XL. Nursing of one aged patient with pulmonary fibrosis conducting early exercise after lung transplantation[J]. Chin J Nurs, 2017,52(8):1015-1017.
[6]	潘红, 黄琴红, 许红阳, 等. 1例再次肺移植治疗重度原发性移植物功能丧失患者的护理[J]. 中华护理杂志, 2016,51(10):1272-1275.
	Pan H, Huang QH, Xu HY, et al. Nursing care of a patient with severe primary graft dysfunction after lung retransplantation[J]. Chin J Nurs, 2016,51(10):1272-1275.
[7]	潘红, 蔡英华, 许正红, 等. 营养支持联合早期运动对肺移植术后患者康复的影响[J]. 护理学杂志, 2019,34(9):42-44.
	Pan H, Cai YH, Xu ZH, et al. Effect of nutrition support combining with early exercise on lung rehabilitation in patients undergoing lung transplantation[J]. J Nurs Sci, 2019,34(9):42-44.
[8]	Padkao T, Boonsawat W, Jones CU. Conical-PEP is safe,reduces lung hyperinflation and contributes to improved exercise endurance in patients with COPD:a randomised cross-over trial[J]. J Physiother, 2010,56(1):33-39. DOI URL
[9]	Donna Frownfelter, Elizabeth Dean编. 郭琪,曹鹏宇,喻鹏铭主译. 心血管系统与呼吸系统物理治疗:证据到实践[M]. 北京: 北京科学技术出版社, 2017: 66.
	Donna Frownfelter, Elizabeth Dean edited. Guo Q,Cao PY,Yu PM translate. Cardiovascular and respiratory system physical therapy:evidence to practice[M]. Beijing: Beijing Science and Technology Press, 2017: 66.
[10]	Sun X, Feng J, Shi J. Pregnancy and pulmonary hypertension:an exploratory analysis of risk factors and outcomes[J]. Medicine(Madr), 2018,97(44):e13035.
[11]	Collins EG, Bauldoff G, Carlin B, et al. Clinical competency guidelines for pulmonary rehabilitation professionals[J]. J Car-diopulm Rehabilitation Prev, 2014,34(5):291-302.
[12]	卢山, 孙小玲, 夏萍. 70岁以上高龄心脏瓣膜手术患者术后发生便秘的影响因素分析及对策[J]. 中西医结合护理(中英文), 2020,6(1):10-15.
	Lu S, Sun XL, Xia P. Analysis of factors influencing postoperative constipation in patients with heart valve surgery over 70 years old and its countermeasures[J]. Nurs Integr Tradit Chin West Med, 2020,6(1):10-15.
[13]	Choi J, Hergenroeder AL, Burke L, et al. Delivering an inho-me exercise program via telerehabilitation:a pilot study of lung transplant go(LTGO)[J]. Int J Telerehab, 2016,8(2):15-26. DOI URL
[14]	潘红, 黄琴红, 许正红, 等. 肺移植术后呼吸机依赖患者的肺康复护理[J]. 护理学杂志, 2018,33(14):39-41.
	Pan H, Huang QH, Xu ZH, et al. Pulmonary rehabilitation nursing for ventilator-dependent patients after lung transplantation[J]. J Nurs Sci, 2018,33(14):39-41.
[15]	米元元, 黄培培, 董江, 等. 危重症患者肠内营养不耐受预防及管理的最佳证据总结[J]. 中华护理杂志, 2019,54(12):1868-1876.
	Mi YY, Huang PP, Dong J, et al. Best evidence summary for prevention and management of enteral feeding intolerance in critically ill patients[J]. Chin J Nurs, 2019,54(12):1868-1876.
[16]	deVito Dabbs A, Terhorst L, Song MK, et al. Quality of recipient-caregiver relationship and psychological distress are correlates of self-care agency after lung transplantation[J]. Clin Transplant, 2013,27(1):113-120. DOI URL
[17]	宫玉翠, 陈洁雅, 李平东, 等. 慢性呼吸疾病肺康复护理专家共识[J]. 中华护理杂志, 2020,55(5):709-710.
	Gong YC, Chen JY, Li PD, et al. Expert consensus on pulmonary rehabilitation nursing of chronic respiratory diseases[J]. Chin J Nurs, 2020,55(5):709-710.
[18]	Gosselink R, Bott J, Johnson M, et al. Physiotherapy for adult patients with critical illness:recommendations of the European respiratory society and European society of intensive care medicine task force on physiotherapy for critically ill patients[J]. Intensive Care Med, 2008,34(7):1188-1199. DOI URL
[19]	中华医学会心血管病学分会肺血管病学组, 中华心血管病杂志编辑委员会. 中国肺高血压诊断和治疗指南2018[J]. 中华心血管病杂志, 2018,46(12):933-964.
	Working Group on Pulmonary Vascular Diseases of Chinese Society of Cardiology of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology. Chinese guidelines for diagnosis and treatment of pulmonary hypertension 2018[J]. Chin J Cardiol, 2018,46(12):933-964.