中华护理杂志 ›› 2024, Vol. 59 ›› Issue (9): 1114-1117.DOI: 10.3761/j.issn.0254-1769.2024.09.013

• 疑难病例护理 • 上一篇    下一篇

1例行机械循环辅助桥接心脏移植患者的术前护理

李旭琴(), 冯洁惠, 黄昉芳(), 俞超, 梁诗雨, 王晓, 李旭芳, 朱含   

  1. 311100 杭州市 浙江大学医学院附属第一医院综合监护室(李旭琴,黄昉芳,俞超),心脏大血管外科(冯洁惠,李旭芳,朱含),护理部(梁诗雨),急诊ICU(王晓)
  • 收稿日期:2023-05-26 出版日期:2024-05-10 发布日期:2024-04-28
  • 通讯作者: 黄昉芳,E-mail:huangfangfang517@zju.edu.cn
  • 作者简介:李旭琴:女,本科,主管护师,E-mail:843097724@qq.com
  • 基金资助:
    浙江省医药卫生科技计划项目(2023KY711);浙江大学医学院附属第一医院护理学科建设科研项目(2022ZYHL010)

Nursing care of a patient before operation with mechanical circulation-assisted bridging heart transplantation

LI Xuqin(), FENG Jiehui, HUANG Fangfang(), YU Chao, LIANG Shiyu, WANG Xiao, LI Xufang, ZHU Han   

  • Received:2023-05-26 Online:2024-05-10 Published:2024-04-28

摘要:

总结1例急性心肌梗死合并心源性休克患者行机械循环辅助桥接心脏移植的术前护理。护理要点如下:急性期实施一体化救护、快速启动体外心肺复苏,多学科协作、确保机械循环辅助下患者的安全转运;桥接期做好体外膜肺氧合、主动脉内球囊反搏及连续性肾脏替代治疗联合运行护理,目标导向性抗凝管理,机械循环辅助下导管相关感染预防以及连续动态神经功能监测等。患者顺利渡过心脏移植等待期,入院后21 d实施心脏移植,随访1年,患者恢复良好。

关键词: 急性心肌梗死, 心源性休克, 机械循环辅助, 心脏移植, 护理

Abstract:

To summarize the nursing care of a patient with acute myocardial infarction complicated with cardiogenic shock before operation. The main nursing points are as follows:in the acute stage,the integrated rescue was implemented with rapid on-machine coordination of external cardiopulmonary resuscitation,multidisciplinary collaboration to ensure safe patient transport;during the bridging period,the combined operation care of extracorporeal membrane oxygenation,intra-aortic balloon counter pulsation and continuous kidney replacement therapy was carried out with goal-oriented anticoagulation care,prevention of catheter-related infection with the assistance of mechanical circulation,and neurological function monitoring. The patient successfully passed the waiting period for heart transplantation and underwent heart transplantation 21 days after admission. With the follow-up for 1 year,the patient recovered well.

Key words: Acute Myocardial Infarction, Cardiogenic Shock, Mechanical Circulatory Support, Heart Transplantation, Nursing Care