摘要
埋藏式心脏复律除颤器(Implantable Cardioverter Defibrillator,ICD)是心脏植入性电子装置(Cardiac Implantable Electronic Device,CIED)的一种,它是治疗恶性心律失常的重要手段,该治疗方案已被广泛应用于临床。ICD置入术后规范化的护理及病情观察对患者的预后至关重要,在护理该类患者过程中一定要严密监测患者的心率及心律、血钾情况,重视患者的主诉及心理问题,加强局部伤口的观察,警惕术后并发症的发生。较术后囊袋感染、电极脱位等并发症而言,术后并发气胸的情况较为少见。本研究总结一例ICD术后并发气胸行胸腔闭式引流患者的护理体会,通过文献查阅分析此患者术后发生气胸的原因,为该类患者的护理提供借鉴。该患者的护理要点主要包括ICD术后规范化监测、伤口护理、预防感染、早期康复、健康教育、心理及睡眠管理、气胸及胸腔闭式引流管的护理等。在护理该患者过程中,比较突出的问题有以下两点,一是伤口制动与早期运动康复之间度的把握,二是该患者心理问题突出,在经过充分的评估后立即开展对应的治疗措施,上述两个问题得以处理。通过及时的治疗和护理,取得良好的治疗效果,患者康复出院,后续随访,患者身体状态良好,ICD运转正常。现将此案例做详细汇报,供广大护理同仁参考。
Implantable cardioverter defibrillator(ICD)is a kind of cardiac implantable electronic device,which is an important means to treat malignant arrhythmias,and the treatment scheme has been widely used in clinic.Standardized nursing and condition observation after ICD implantation are crucial to the prognosis of patients.In the process of nursing such patients,the heart rate,heart rhythm,and blood potassium of patients must be closely monitored,the main complaints and psychological problems of patients should be paid attention to,the observation of local wounds should be strengthened,and the occurrence of postoperative complications should be vigilant.Postoperative pneumothorax is rare compared with postoperative sac infection,electrode dislocation and other complications.This paper summarizes the nursing experience of one patient with pneumothorax after thoracic closed drainage with a buried automatic cardioverter defibrillator,and analyzes the causes of postoperative pneumothorax in this patient through literature review,in order to provide reference for the subsequent nursing of such patients.The main nursing points of this patient mainly include standardized monitoring after ICD operation,wound nursing,infection prevention,early rehabilitation,health education,psychological and sleep management,and nursing of pneumothorax and thoracic closed drainage tube.In the process of nursing this patient,there were the following two prominent problems:first,the measurement between wound braking and early exercise rehabilitation;second,the patient had prominent psychological problems.After adequate evaluation,corresponding treatment measures are carried out immediately,and the above two problems were properly dealt with.Through timely treatment and nursing,the good treatment effects were obtained,and the patient recovered and was discharged from hospital.In the follow-up,the patient is in good physical condition,and the ICD works normally.Now this case is reported in details for the reference of the general nursing staff.
出处
《中医临床研究》
2025年第12期120-123,共4页
Clinical Journal Of Chinese Medicine
关键词
埋藏式自动心脏复律除颤器
气胸
胸腔闭式引流
护理
Implantable automatic cardioverter defibrillator
Pneumothorax
Thoracic closed drainage
Nursing
