Nursing of a critically ill patient undergoing transcatheter aortic valve replacement combined with coronary stent implantation (1例危重症患者一站式经导管主动脉瓣置换术联合冠状动脉支架植入术的护理)

Abstract

This paper summarized the nursing measures for a critically ill patient undergoing transcatheter aortic valve replacement combined with coronary stent implantation. Giving the increasing surgical risk caused by issues such as advanced age and concomitant diseases, the one-stop minimally invasive surgery was carried out, in combination of transcatheter aortic valve replacement combined with coronary stent implantation. The endotracheal intubation and temporary pacemaker implantation were performed intraoperatively. The intra- aortic ballon pump (IABP) insertion and extracorporeal membrane oxygenation (ECMO) were performed as rescue mechanical support for maintenance of blood pressure. Given the upper gastro-intestinal bleeding and other complications after surgery, comprehensive nursing interventions were carried out including preoperative evaluation and psychological care, vital signs monitoring, medical equipment maintenance, wound care and prevention of complications. The patient (报告1例危重症患者行一站式经导管主动脉瓣置换术(TAVR)联合冠状动脉支架植入术的护理体会。患者基础疾病较多, 年龄偏大, 手术难度及风险增加。术中采用一站式微创手术, 同时将冠状动脉支架植入术及TAVR联合进行, 术中行气管插管, 临时起搏器植入术。由于患者血压无法维持, 在主动脉内球囊反搏(IABP)及体外膜肺氧合(ECMO)支持及辅助下进行。术后患者合并消化道出血等因素, 增加术后护理难度。医护团队加强术前评估和心理护理, 术后严密监测患者生命体征, 做好各种仪器设备护理、伤口及并发症观察护理等。)

Keywords

• transcatheter aortic valve replacement
• aortic valve stenosis
• coronary stent implantation
• complication
• perioperative nursing
• 经导管主动脉瓣置换术
• 主动脉瓣狭窄
• 冠状动脉支架植入
• 并发症
• 围手术期护理