报告1例心脏瓣膜置换术后低心排综合征行体外膜肺氧合无缝衔接体外循环患者的护理体会。针对患者病情危重复杂、进展速度快,采取一系列措施,包括多学科协作体外循环下床边开胸止血,积极纠正低心排的可逆因素;床边体外循环与体外膜肺氧合（extracorporeal membrane oxygenation,ECMO）无缝衔接的管理,体外循环术后ECMO抗凝的精准化管理,静脉-动脉ECMO运行期间加强脑功能、容量及远端肢体缺血的监测与管理,保证心、肺、脑等重要脏器血供和氧供充足,且无致命性并发症发生,患者顺利度过泵衰竭期。经过6 d精心的治疗和护理,患者心功能恢复至预期目标,成功撤离ECMO。
The nursing experience of a patient with low cardiac output syndrome after heart valve replacement and treated by extracorporeal membrane oxygenation combined with cardiopulmonary bypass was reported. In view of the patient's critical and complex condition and rapid progression,a series of measures were taken,including bedside thoracotomy for hemostasis under cardiopulmonary bypass by multidisciplinary collaboration,actively correcting reversible factors leading to low cardiac output,bedside seamless management of cardiopulmonary bypass and extra corporeal membrane oxygenation（ECMO）,the precision management of ECMO anticoagulation after cardiopulmonary bypass,monitoring and management of brain function,capacity and distal limb ischemia during the running of venous-arterial ECMO to ensure sufficient blood and oxygen supply of heart,lung,brain and other important organs and no fatal complications,make patients go through pump failure. After 6 days of careful treatment and nursing,the cardiac function of the patient recovered to the expected goal,and the ECMO was successfully evacuated.
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