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 (3): 328-330.doi: 10.3761/j.issn.2096-7446.2026.03.014

• 重症护理研究 • 上一篇    下一篇

肥厚型梗阻性心肌病患者行经心尖室间隔心肌旋切术的护理

朱旭菁1(), 陈霞1, 黄翱黎1, 冯洁惠2,*(), 李少玲3   

  1. 1 浙江大学医学院附属第一医院心脏大血管外科 杭州市 310000
    2 浙江大学医学院附属第一医院护理部 杭州市 310000
    3 浙江大学医学院附属第一医院心血管内科 杭州市 310000
  • 收稿日期:2025-04-25 出版日期:2026-03-10 发布日期:2026-03-02
  • 通讯作者: *冯洁惠，E-mail：1503026@zju.edu.cn
  • 作者简介:朱旭菁：女，本科，主管护师，E-mail：623076929@qq.com

Nursing care for patients with hypertrophic obstructive cardiomyopathy undergoing transapical beating-heart septal myectomy

ZHU Xujing1(), CHEN Xia1, HUANG Aoli1, FENG Jiehui2,*(), LI Shaoling3   

  1. 1 Department of Cardiac and Vascular Surgery， the First Affiliated Hospital，School of Medicine，Zhejiang University， Hangzhou 310000， China
    2 Department of Nursing， the First Affiliated Hospital，School of Medicine，Zhejiang University， Hangzhou 310000， China
    3 Department of Cardiovascular Medicine， the First Affiliated Hospital，School of Medicine，Zhejiang University， Hangzhou 310000， China
  • Received:2025-04-25 Online:2026-03-10 Published:2026-03-02
  • Contact: *FENG Jiehui，E-mail：1503026@zju.edu.cn

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摘要：

总结5例肥厚型梗阻性心肌病行经心尖室间隔心肌旋切术患者的围手术期护理体会。针对患者术前心源性猝死发生率高、胃肠道准备特殊、术后容量管理要求高、并发症发生风险大，以及出院指导需要个体化等问题，采取以下护理措施：术前实施风险分层干预，保障术前过渡安全；优化超声引导肠道准备，确保术中视野清晰；术后实施滴定式容量管理，稳定血流动力学；构建多维度预警体系，实现并发症早期识别；出院前开展个体化主动健康干预，提升生活质量。5例患者经过精心治疗和护理，均好转出院。出院1个月随访，5例患者左心室流出道压力明显较术前降低，整体状况良好。

关键词: 心尖肥厚型心肌病, 室间隔切除术, 围手术期护理, 心脏康复

Abstract:

This study summarized the perioperative nursing experience of five patients with hypertrophic obstructive cardiomyopathy undergoing transapical beating-heart septal myectomy. In response a high preoperative risk of sudden cardiac death，the need for specialized bowel preparation，stringent postoperative volume management，elevated complication risks，and the necessity for tailored discharge planning，the following nursing measures were implemented. Those included risk-stratified preoperative interventions to ensure safe transition to surgery，optimized ultrasound-guided bowel preparation to achieve a clear surgical field，titrated volume management after surgery to maintain hemodynamic stability，a multi-dimensional early warning system for timely complication detection，and individualized discharge education to support recovery and improve quality of life. All five patients recovered successfully and were discharged. At one-month follow-up，five patients showed a significant decrease in left ventricular outflow tract pressure compared to preoperative levels，with overall good condition.

Key words: Apical Hypertrophic Cardiomyopathy, Septal Myectomy, Perioperative Care, Cardiac Rehabilitation