关键词:

感染性心内膜炎, 肠系膜上动脉瘤, 围手术期护理

Abstract:

Objective　To explore the perioperative nursing experiences for superior mesenteric artery aneurysm (SMAA) associated with infective endocarditis (IE). Methods　Four patients diagnosed with SMAA associated with IE were admitted to Guangdong Provincial People's Hospital from March 2022 to June 2024. There were 2 males and 2 females, aged 27-53 (37.25±11.27) years, with a body mass index of 14.18-18.14 (16.75±1.76) kg/m², preoperative cardiac function classification of the New York Heart Association (NYHA): 1 case of grade Ⅱ, 1 case of grade Ⅲ, and 2 cases of grade Ⅳ. The key aspects and measures of perioperative nursing were analyzed, including pre-procedural observation prior to SMAA endovascular treatment, post-embolization nursing care for the mesentery, parenteral nutrition support, anti-infective medication nursing, maintenance of cardiac function, pain nursing, and monitoring for bleeding complications after cardiac surgery. Paired t test was used for statistical analysis. Results　All four patients successfully completed both cardiac surgery and mesenteric embolization procedures. The duration of mechanical ventilation was 6-19 (13.25±6.29) h, the ICU stay was 1-4 (2.50±1.30) d, and the total hospital stay was 9-31 (16.75±9.81) d. Complications included one case each of perioperative SMAA rupture with local hematoma formation, distal occlusion of the superior mesenteric artery, mural thrombosis, arrhythmia, and postoperative hemorrhage. All four patients were discharged after comprehensive nursing care; notably, their albumin and hemoglobin levels improved compared to admission values [(37.30±5.96) g/L vs. (28.80±3.90) g/L, (104.50±10.08) g/L vs. (86.50±14.93) g/L] (both P>0.05). The nursing satisfaction score ranged from 96 to 99 (97.75±1.26) points, all of which were satisfactory. No recurrence of IE or SMAA was observed during 3-12 months of follow-up. Conclusion　The proactive implementation of preventive measures alongside individualized nursing strategies during the perioperative period can significantly reduce complication rate while promoting early recovery in patients and enhancing overall patient satisfaction on nursing care.

Key words:

Infective endocarditis, Superior mesenteric artery aneurysm, Perioperative nursing care