中华护理杂志 ›› 2025, Vol. 60 ›› Issue (10): 1261-1264.DOI: 10.3761/j.issn.0254-1769.2025.10.017

• 疑难重症护理 • 上一篇    下一篇

1例Uhl’s畸形患儿行复杂心脏手术的术后护理

刘亚飞(), 邢海英, 莫粤, 李梦然, 张茜(), 孙阳雪   

  1. 100037 北京市 中国医学科学院阜外医院小儿外科恢复室(刘亚飞,邢海英,莫粤,李梦然,张茜),小儿心外科二病区(孙阳雪)
  • 收稿日期:2024-08-21 出版日期:2025-05-20 发布日期:2025-05-13
  • 通讯作者: 张茜,E-mail:495456400@qq.com
  • 作者简介:刘亚飞:女,本科,副主任护师,护士长,E-mail:Raikkonen-liu@163.com
  • 基金资助:
    中央高水平医院临床科研业务费资助项目(2023-GSP-GG-19)

The postoperative nursing care of a child with Uhl’s anomaly undergoing complex heart surgery

LIU Yafei(), XING Haiying, MO Yue, LI Mengran, ZHANG Qian(), SUN Yangxue   

  • Received:2024-08-21 Online:2025-05-20 Published:2025-05-13

摘要:

总结1例Uhl’s畸形患儿行复杂心脏手术的术后护理经验。护理要点包括实施目标导向的液体负平衡管理,促进心功能恢复;进行压力负荷管理并密切监测心率、心律,维持循环系统的稳定;密切监测上腔中心静脉压,实时关注肺动脉压力变化;采取精细化综合管理,避免肺动脉压力异常升高;尽早撤除有创机械通气,循序渐进开展无创呼吸机脱机训练;出血与抗凝的协同管理;采取多种措施积极预防并发症;全方位、多角度预防和控制感染;制订个体化心脏康复训练及营养干预方案。患儿术后第9天由儿童重症监护室转回儿科病房,术后第11天因右心房血栓转回儿童重症监护室住院13 d,平稳后转回儿科病房,10 d后康复出院。术后1、3个月复查,预后良好。

关键词: Uhl’s畸形, 围手术期护理, 儿科护理学

Abstract:

To summarize the postoperative nursing experience for a child with Uhl’s anomaly undergoing complex heart surgery. Nursing key points include implementing goal-oriented liquid negative balance management to promote the recovery of cardiac function;carrying out pressure load management and closely monitoring the heart rate and rhythm to maintain the stability of the circulatory system;closely monitoring the central venous pressure in the upper chamber and paying attention to the changes of the pulmonary artery pressure in real time;adopting a refined integrated management to avoid an abnormal rise in the pulmonary artery pressure;withdrawing invasive mechanical ventilation as early as possible and carrying out the non-invasive ventilator deconditioning training in an orderly manner;the synergistic management of bleeding and anticoagulation;the adoption of various measures to actively prevent complications;the prevention and control of infections in an all-round and multi-angle manner;the formulation of individualized cardiac rehabilitation training and nutritional intervention programs. The child was transferred from the pediatric intensive care unit back to the pediatric ward on postoperative day 9,transferred back to the pediatric intensive care unit on postoperative day 11 for 13 d for right atrial thrombus, stabilized and transferred back to the pediatric ward,and discharged after 10 d for recovery. The prognosis showed good recovery after 1 month and 3 months.

Key words: Uhl’s Anomaly, Perioperative Nursing, Pediatric Nursing