目的 總結在三維標測系統Carto 3指導下射頻消融治療特發性室速患者的護理方法。 方法 對2010年11月－2011年10月收治的62例特發性室速患者，采用Carto 3系統進行心室標測和消融治療，并予以周全細致的護理。 結果 本組61例患者順利完成射頻消融術，1例因誘發室顫后停止手術。術后隨訪6個月，3例出現既往相同形態室速，其余58例癥狀較前均有不同程度的緩解，未發生明顯心動過速，手術成功率為93.55%。 結論 Carto 3系統指導下的特發性室速射頻治療安全、高效，可減少射線透視量，恰當細致的護理配合是手術獲得成功的基礎與保障。
Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for aortic stenosis. Clinical practice reduces the length of hospital stay of patients and promotes their early safe discharge home by adopting minimalist approach TAVR and standardized postoperative care. Foreign studies have shown that early discharge from hospital is safe and feasible, which can reduce medical costs and complications, but there are few relevant research in China. This article mainly reviews the assessment, influencing factors, and management strategies to promote early discharge of patients after TAVR, with the aim of providing references for the early discharge management practice of medical staff.
Transcatheter aortic valve replacement (TAVR) can effectively treat symptomatic severe aortic valve stenosis, and its applicable population is gradually expanding. The perioperative and rehabilitation care of TAVR is an important influencing factor for the success of the surgery. The release of the Chinese Expert Consensus on Perioperative Nursing of Transcatheter Aortic Valve Replacement has promoted the homogenization and high-quality care of TAVR patients in China. In order to better understand the key issues of TAVR perioperative nursing and serve clinical practice, this article provides a detailed interpretation of the above consensus based on five key issues of preoperative nursing, intraoperative monitoring, postoperative intensive care nursing, ward nursing, and nutritional assessment.
目的 分析總結經導管主動脈瓣置入的術中護理要點，以指導臨床術中護理。 方法 回顧性分析2012年4月－5月新開展經股動脈逆行法經導管主動脈瓣置入術3例患者的臨床資料。術前備齊手術用物及急救藥品、術中協助患者正確體位，準確使用臨時起搏器、除顫儀、認真做好病情及并發癥觀察和護理，總結術中臨床護理方法。 結果 經導管主動脈瓣置入手術順利成功，術中護理效果滿意，無因物品或藥品準備不齊及護理不當而影響手術進程、造成患者意外損傷及并發癥發生。 結論 經導管主動脈瓣置入術，術前備齊相應的導管導絲，術中操作規范細致、及時、準確傳遞用物、認真進行臨床觀察和護理，手術順利、成功無不良事件發生及并發癥發生。
Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.