1例植入皮下心律转复除颤器患儿频发室颤的急救与护理

doi:10.3761/j.issn.0254-1769.2023.22.004

摘要/Abstract

摘要：

总结1例已植入皮下心律转复除颤器的早期复极综合征患儿频发室颤的急救与护理经验。主要护理措施：及时识别室颤，预防心律转复除颤器电量耗竭及心源性猝死；提前制订转运方案，降低院内转运风险；给予体外膜氧合支持治疗，加强血流动力学及心功能监测；采取保护性措施，预防医源性感染；适度镇静、镇痛，促进大脑功能恢复；实施个性化健康教育，远离疾病诱发因素；对家长进行院前急救技能培训，制订随访计划。经过精心的治疗与护理，患儿未再发心律失常，心功能明显改善，肺部炎症消失，未发生医源性感染，活动能力及语言表达能力均恢复至发病前，住院20 d后好转出院。出院后1个月随访恢复良好，回归正常生活。

关键词: 早期复极综合征, 植入型心律转复除颤器, 室颤, 危重病, 儿科护理学

Abstract:

To summarize the nursing experience of an adolescent with early repolarization syndrome who had implanted a subcutaneous implantable cardioverter defibrillator（ICD） and experiences frequent ventricular fibrillation. The main nursing care were as follows：recognizing a ventricular fibrillation attack and emergency care；risk prevention and handling in transportation；prevention of iatrogenic infection and strengthening protective isolation；promoting the recovery of brain function；personalized health education；pre-hospital first aid skills training for families. After careful treatment and nursing，the patient did not recur arrhythmia，and heart function had improved significantly，and the pulmonary inflammation disappeared. No medical-acquired infections occurred during hospitalization. The patient’s motor ability and language expression ability recovered to the baseline，and was discharged on the 20th day of admission. A month after discharge，the patient recovered well and could study and live normally.

Key words: Early Repolarization Syndrome, Implantable Cardioverter Defibrillator, Ventricular Fibrillation, Critical Illness, Pediatric Nursing

秦庆祝, 杜宜修, 易银萍, 李一聪, 陶琳. 1例植入皮下心律转复除颤器患儿频发室颤的急救与护理[J]. 中华护理杂志, 2023, 58(22): 2716-2720.

QIN Qingzhu, DU Yixiu, YI Yinping, LI Yicong, TAO Lin. The nursing care of a child with frequent ventricular fibrillation after implantation of a subcutaneous cardioverter defibrillator[J]. Chinese Journal of Nursing, 2023, 58(22): 2716-2720.

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