总结12例体外膜肺氧合（extracorporeal membrane oxygenation,ECMO）支持下急性心肌梗死合并心搏骤停患者行经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）的护理经验。护理要点：术前高质量心肺复苏;积极快速完善各项检查;尽早建立ECMO;安全有效院内转运;最短时间内冠脉血运重建;术中病情监测和管道护理;镇痛镇静护理;早期预防并发症和术后护理。12例中4例患者好转出院,其中3例患者病情稳定,定期门诊随访;1例患者遗留神经功能障碍。
To summarize the nursing experience of 12 patients with acute myocardial infarction combined with cardiac arrest undergoing percutaneous coronary intervention（PCI） supported by extracorporeal membrane oxygenation（ECMO）. Nursing points：preoperative high-quality cardiopulmonary resuscitation; Active and quick completion of various inspections; Establishment of ECMO as soon as possible; Safe and effective hospital transfer; Coronary revascularization in the shortest time; Intraoperative condition monitoring and pipeline nursing; Analgesia and sedation nursing; Early prevention of complications and postoperative care. Among the 12 cases,4 patients improved and were discharged,of which 3 patients were in stable condition and were followed up regularly and one patient left neurological dysfunction.
[1] 郑喜胜,刘志远,王松,等. IABP治疗急性心肌梗死合并心源性休克患者预后的影响因素分析[J]. 中国循证心血管医学杂志,2019,11(8):931-934,937.
Zheng XS,Liu ZY,Wang S,et al.Analysis of prognostic factors of elderly patients with acute myocardial infarction complicated with cardiogenic shock treated with IABP[J]. Chin J Evid Based Cardiovasc Med,2019,11(8):931-934,937.
[2] 朱梦莉,王智超,朱维芳,等. 大面积心肌梗死合并心搏骤停患者实施EICU针对性护理干预模式与感染预防的研究[J]. 中华医院感染学杂志,2018,28(4):504-507.
Zhu ML,Wang ZC,Zhu WF,et al.Study on targeted nursing intervention mode of emergency intensive care unit inpatients with large area myocardial infarction complicated with cardiac arrest and prevention of infection[J]. Chin J Nosocomiology,2018,28(4):504-507.
[3] 中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会. 中国经皮冠状动脉介入治疗指南(2016)[J]. 中华心血管病杂志,2016,44(5):382-400.
Interventional Cardiology Group of Cardiology Branch of Chinese Medical Association,Thrombotic Prevention and Control Professional Committee of Cardiovascular Physician Branch of Chinese Medical Doctor Association,Editorial Committee of Chinese Journal of Cardiovascular Disease. Chinese guidelines for percutaneous coronary intervention(2016)[J]. Chin J Cardiol,2016,44(5):382-400.
[4] 贾亚南,蒋培余,金静芬. 高质量心肺复苏的应用与应对策略研究现状[J]. 中国护理管理,2016,16(2):274-277.
Jia YN,Jiang PY,Jin JF.The Current status of application and coping strategies of high quality cardiopulmonary resuscitation[J]. Chin Nurs Manag,2016,16(2):274-277.
[5] 王钰炜,周帅帅,林高兴,等. 创伤性心搏骤停患者应用体外膜肺氧合治疗的急救护理[J]. 中华急危重症护理杂志,2021,2(1):87-90.
Wang YW,Zhou SS,Lin GX,et al.Emergency care of a patient with traumatic cardiac arrest by extracorporeal membrane oxygenation[J]. Chin J Emerg Crit Care Nurs,2021,2(1):87-90.
[6] 潘红,黄琴红,蔡英华,等. 13例体外膜肺氧合治疗危重患者院内转运的护理[J]. 中华护理杂志,2017,52(5):561-563.
Pan H,Huang QH,Cai YH,et al.Nursing care of 13 critically ill patients with extracorporeal membrane oxygenation for intra-hospital transfer[J]. Chin J Nurs,2017,52(5):561-563.
[7] 汪贝,汪晓筱,张健,等. 体外膜肺氧合桥接心脏移植术的护理[J]. 中华护理杂志,2019,54(8):1235-1238.
Wang B,Wang XX,Zhang J,et al.The nursing for patients with extracorporeal membrane oxygenation before heart transplantation[J]. Chin J Nurs,2019,54(8):1235-1238.
[8] 陈帅,宁彬. STEMI患者急诊PCI术中在ACT监测下应用比伐芦定或肝素的安全性及其影响因素分析[J]. 中国循证心血管医学杂志,2021,13(4):464-468.
Chen S,Ning B.Safety and influencing factors of bivalirudin or heparin administrated under activated clotting time monitoring in STEMI patients undergone emergency PCI[J]. Chin J Evid Based Cardiovasc Med,2021,13(4):464-468.
[9] 周兴梅,方芳,张瑶,等. 成人体外膜氧合支持下转运不良事件研究进展[J]. 护理研究,2018,32(22):3487-3491.
Zhou XM,Fang F,Zhang Y,et al.Research progress on adverse events of transport under support of extracorporeal membrane oxygenation in adults[J]. Nurs Res Chin,2018,32(22):3487-3491.
