心律失常射频消融术并发心脏压塞患者围手术期抢救护理的范围综述

doi:10.3761/j.issn.2096-7446.2024.06.016

摘要/Abstract

摘要： 目的对心律失常行射频消融术患者围手术期发生心脏压塞的危险因素及抢救护理进行范围综述,为完善围手术期管理、改善患者预后提供参考。方法采用Arksey和O`Malley的范围综述方法为框架,检索中国知网、中国生物医学文献数据库、维普中文科技期刊数据库、万方数据库、Cochrane Library、PubMed、Web of Science、Embase、CINAHL数据库中发表的心律失常患者行射频消融术并发心脏压塞的相关研究,检索时限为建库至2024年1月31日。对纳入文献进行筛选、汇总,并对危险因素进行归纳总结,得出针对危险因素的抢救护理对策。结果最终纳入11篇文献,研究设计以病例对照为主,多数研究纳入射频消融术中及术后发生的心脏压塞,少数研究仅纳入术中心脏压塞。心律失常患者行射频消融术围手术期并发心脏压塞的发生率为0.61%~2.3%,且不同研究中心报告发生率差异较小,影响因素主要包括患者因素、合并疾病及治疗因素、射频消融术操作相关因素、机构相关因素。抢救护理对策有①迅速识别,精准处置;②人员、设备急救准备;③抢救护理技术应用等。结论心律失常患者射频消融术并发心脏压塞受患者、手术操作及组织因素的影响,未来可综合现有研究结果构建心脏压塞风险预测模型,为临床早期识别风险并制订相应的预防策略提供参考。

关键词: 心律失常, 射频消融, 心脏压塞, 危险因素, 抢救护理, 范围综述

Abstract: Objective To review the risk factors and rescue nursing for perioperative cardiac tamponade in patients with arrhythmia undergoing radiofrequency ablation,so as to provide a reference for improving perioperative management and prognosis of patients. Methods Using Arksey and O ‘Malley‘s scoping review approach as a framework,CNKI,CBM,VIP Database,Wanfang Database,Cochrane Library,PubMed,Web of science,Embase,CINAHL database were searched for relevant studies on cardiac tamponade after radiofrequency ablation in patients with arrhythmia. The search time limit was from the establishment of the database to January 31,2024. The included literature was screened and summarized,the risk factors were summarized,and the rescue and nursing countermeasures for risk factors were obtained. Results Among the 11 included studies,the study designs were mainly case-control study,most studies included cardiac tamponade during and after radiofrequency ablation,and a few studies only included intraoperative cardiac tamponade. The incidence of perioperative cardiac tamponade in patients with arrhythmia undergoing radiofrequency ablation was 0.61% to 2.3%,and there is little difference in the incidence reported by different research centers. The influencing factors mainly included patient factors,combined diseases and treatment factors,radiofrequency ablation procedure-related factors and organizational factors. The rescue nursing strategies included rapid identification and accurate treatment of cardiac tamponade,personnel and equipment preparation,application of rescue nursing technology. Conclusion Complicated cardiac tamponade of radiofrequency ablation in patients with arrhythmia is affected by the patient,surgical operation and organizational factors. In the future,the risk prediction model of cardiac tamponade can be built based on the existing research,providing references for early clinical risk identification and corresponding prevention strategies.

Key words: Arrhythmia, Radiofrequency Ablation, Cardiac Tamponade, Risk Factors, Rescue Nursing, Scoping Review

赵飞, 陈洁莹, 邵翠梅, 冯佳, 金静芬. 心律失常射频消融术并发心脏压塞患者围手术期抢救护理的范围综述[J]. 中华急危重症护理杂志, 2024, 5(6): 570-576.

ZHAO Fei, CHEN Jieying, SHAO Cuimei, FENG Jia, JIN Jingfen. The perioperative rescue nursing for complicated pericardial tamponade in arrhythmia patients undergoing radiofrequency ablation：a scoping review[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(6): 570-576.

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