总结41例肥厚型梗阻性心肌病患者行经皮心肌内室间隔射频消融术(percutaneous intramyocardial septal radiofrequency ablation,PIMSRA)的护理经验。2021年3月—2022年3月开展PIMSRA手术41例,其中9例(21.95%)出现并发症。针对该组患者发生心包积液、室间隔穿孔、胸腔积液并发症,予严密血流动力学监测,快速识别并有效救护;全面落实精细化护理,促进疾病康复;加强出院指导,提高患者自我管理。41例均完成手术,经过精心治疗和护理,康复出院。随访1年,97.56%的患者纽约心功能分级在1级或2级。
To summarize the nursing care of 41 patients with hypertrophic obstructive cardiomyopathy treated by percutaneous intramyocardial septal radiofrequency ablation(PIMSRA). From March 2021 to March 2022,41 patients underwent PIMSRA,and 9 patients(21.95%) developed related complications. In view of the complications of pericardial effusion,ventricular septal perforation and pleural effusion in this group of patients,close hemodynamics monitoring,rapid identification,timely and effective rescue were taken. Fine nursing was carried out in an all-round way to promote disease rehabilitation. Strengthening discharge guidance,improve patient self-management were implemented. All the 41 patients finished the operation and were discharged after careful treatment and nursing. With one year of follow-up,the New York‘s heart function grade was evaluated,97.56% of patients were grade 1 or 2.
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