ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1334-1336.doi: 10.3761/j.issn.2096-7446.2026.11.008

• 急症护理研究 • 上一篇    下一篇

老年二尖瓣置换术后心室后壁破裂患者脑出血的预防及护理

邵艳红1(), 李文慧1,*(), 程云清1, 王咏琳2, 凌云2, 贺真3   

  1. 1 南方医科大学附属广东省人民医院心脏大血管外科 广州市 510010
    2 南方医科大学附属广东省人民医院心外重症监护一科 广州市 510010
    3 南方医科大学附属广东省人民医院心外重症监护二科 广州市 510010
  • 收稿日期:2026-02-24 出版日期:2026-11-10 发布日期:2026-11-06
  • 通讯作者: *李文慧，E-mail：471772445@qq.com
  • 作者简介:邵艳红：女，本科，主管护师，E-mail：75182377@qq.com
    作者贡献声明

    邵艳红、李文慧、王咏琳：研究实施、循证分析、论文撰写；程云清、凌云、贺真：研究指导、论文修改

Nursing care for preventing cerebral hemorrhage in an elderly patient with ventricular posterior wall rupture after mitral valve replacement

SHAO Yanhong1(), LI Wenhui1,*(), CHENG Yunqing1, WANG Yonglin2, LING Yun2, HE Zhen3   

  1. 1 Department of Cardiovascular and Great Vascular Surgery， Guangdong Provincial People’s Hospital Affiliated to Southern Medical University， Guangzhou 510010， China
    2 Cardiac Surgery Intensive Care Unit 1， Guangdong Provincial People’s Hospital Affiliated to Southern Medical University， Guangzhou 510010， China
    3 Cardiac Surgery Intensive Care Unit 2， Guangdong Provincial People’s Hospital Affiliated to Southern Medical University， Guangzhou 510010， China.
  • Received:2026-02-24 Online:2026-11-10 Published:2026-11-06
  • Contact: *LI Wenhui，E-mail：471772445@qq.com

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摘要：

总结1例二尖瓣置换术后心室后壁破裂老年患者在体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）联合主动脉内球囊反搏（intra-aortic balloon pump，IABP）支持下，实施阶段性无抗凝策略以预防脑出血的护理体会。针对患者住院期间行多次手术，且同时使用ECMO联合IABP辅助治疗易并发脑出血等问题，采取ECMO与IABP协同监测、阶段性无抗凝管理、多维度监测脑出血、精准容量管理等措施。经过综合治疗与精细化护理，患者未发生脑出血，心功能逐步恢复，术后第7天撤离ECMO，第11天拔除IABP，第19天康复出院。

关键词: 二尖瓣置换术, 颅内出血, 心脏破裂, 体外膜氧合作用, 主动脉内气囊泵, 老年人, 危重病护理

Abstract:

To summarize the nursing experience of implementing a staged anticoagulant-free strategy to prevent cerebral hemorrhage in an elderly patient with ventricular posterior wall rupture after mitral valve replacement supported by extracorporeal membrane oxygenation（ECMO） and intra-aortic balloon pump（IABP）. For the patient who underwent multiple surgeries during hospitalization and was prone to cerebral hemorrhage complications due to combined ECMO and IABP therapy，measures including coordinated ECMO-IABP monitoring，phased anticoagulant-free management，multidimensional cerebral hemorrhage monitoring and precise volume management were adopted. Through comprehensive treatment and meticulous nursing care，the patient avoided cerebral hemorrhage，achieved gradual cardiac function recovery，was successfully weaned off ECMO on postoperative day 7，had IABP removed on day 11，and was discharged recovered on day 19.

Key words: Mitral Valve Replacement, Intracranial Hemorrhages, Heart Rupture, Extracorporeal Membrane Oxygenation, Intra-Aortic Balloon Pumping, Aged, Critical Care Nursing