收稿日期: 2025-02-17
网络出版日期: 2025-11-04
Postoperative care for children with hypertrophic obstructive cardiomyopathy treated with modified extended Morrow procedure
分析2023年1月—2024年11月在某中心行改良扩大Morrow手术的肥厚型心肌病患儿的临床资料,总结术后护理经验。针对该组24例患儿手术方式复杂、术后并发症发生率高等特点及难点,术后严密监测心率、心律,纠正电解质紊乱;遵医嘱应用起搏器或β受体阻滞剂、钙通道阻滞剂等预防心律失常;根据血压、中心静脉压、超声心动图等变化,优化容量负荷;预防低心排血量综合征,遵医嘱使用血管活性药物改善心功能;做好撤除呼吸机前后的气道管理,预防心脏外科术后低氧血症;动态观察引流量,严密监测凝血功能,警惕出血发生。通过精细化护理,24例患儿均顺利转出ICU,为该类患儿的围手术期护理提供了一定的临床经验。
关键词: 儿童; 心肌病; 改良扩大Morrow术; 手术后护理; 危重病护理
冯建辉 , 张倩倩 . 改良扩大Morrow手术治疗儿童肥厚型梗阻性心肌病的术后护理[J]. 中华急危重症护理杂志, 2025 , 6(11) : 1359 -1361 . DOI: 10.3761/j.issn.2096-7446.2025.11.013
This study conducted a retrospective analysis of clinical data from children with hypertrophic cardiomyopathy who underwent the modified extended Morrow procedure at a center between January 2023 and November 2024,to summarize the postoperative nursing experience. In response to the surgical complexity and the elevated risk of postoperative complications,nursing interventions were implemented,including strict monitoring of heart rate and rhythm after surgery and correcting of electrolyte imbalances,arrhythmia prevention through pacemakers or beta-blockers and calcium channel blockers;optimization of volume status guided by blood pressure,central venous pressure,and echocardiography findings to avert low cardiac output syndrome,enhancement of cardiac function with vasoactive agents;respiratory tract management during and after ventilator weaning to prevent post-cardiac surgery hypoxemia;ongoing assessment of drainage volume,stringent coagulation function monitoring and heightened awareness of bleeding events. Thanks to meticulous nursing interventions,all 24 children were safely discharged from the ICU,offering invaluable insights for perioperative nursing care in similar cases.
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