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。

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.