腔内影像联合血管内碎石术治疗冠状动脉钙化病变的护理配合

doi:10.3760/cma.j.issn.1007-1245.2024.04.027

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (4): 646-650.DOI: 10.3760/cma.j.issn.1007-1245.2024.04.027

腔内影像联合血管内碎石术治疗冠状动脉钙化病变的护理配合

于雷贾晓辉

阜外华中心血管病医院介入手术室，郑州　451460

收稿日期:2023-09-01 出版日期:2024-02-01 发布日期:2024-03-08
通讯作者: 贾晓辉，Email：hiyulei900718@163.com
基金资助:
2022年度河南省医学科技攻关计划联合共建项目（LHGJ20220138）

Nursing cooperation of intravascular imaging combined with shockwave balloon intravascular lithotripsy in the treatment of coronary artery calcification

Yu Lei, Jia Xiaohui

Interventional Operating Room, Fuwai Central China Cardiovascular Hospital, Zhengzhou 451460, China

Received:2023-09-01 Online:2024-02-01 Published:2024-03-08
Contact: Jia Xiaohui, Email: hiyulei900718@163.com
Supported by:
Joint Construction Project of Henan Medical Science and Technology Research Plan in 2022 (LHGJ20220138)

摘要/Abstract

摘要：

目的　总结腔内影像联合冲击波球囊导管成形术（即血管内碎石术）治疗冠状动脉钙化病变的护理配合要点。方法　回顾分析2022年6月至2022年10月阜外华中心血管病医院应用冲击波球囊血管内碎石术治疗的6例冠状动脉严重钙化患者（7条血管病变）临床资料，其中男性4例，女性2例，年龄（60.0±6.2）岁，总结6例患者的介入治疗过程及医护配合方法。结果　6例患者介入手术过程顺利，血管内支架膨胀充分、贴壁良好、无限制血流夹层，心肌梗死溶栓试验（TIMI）血流3级。6例患者未发生严重并发症，术后均康复出院，住院天数为5～7 d。结论　腔内影像联合冲击波球囊血管内碎石术可以精准评估并有效处理钙化病变，护理人员熟练掌握腔内影像学及冲击波球囊血管内碎石术基本原理及操作配合要点，做好充分的术前准备，术中密切观察患者生命体征变化，并对可能发生的并发症采取及时有效的护理措施，是手术成功的重要保障。

关键词:

冠状动脉, 钙化, 冲击波球囊, 血管内碎石术, 腔内影像, 护理配合

Abstract:

Objective　To summarize the nursing cooperation points of intravascular imaging combined with shockwave balloon intravascular lithotripsy in the treatment of coronary artery calcification. Methods　A retrospective analysis was made on 6 patients with severe coronary artery calcification (7 vascular lesions) treated by shockwave balloon intravascular lithotripsy in Fuwai Central China Cardiovascular Hospital from June 2022 to October 2022, including 4 males and 2 females, aged (60.0±6.2) years. The process of interventional treatment and doctor-nurse cooperation were retrospectively analyzed. Results　The 6 patients underwent the interventional operation smoothly, the endovascular stent was fully expanded and adhered well to the arterial wall, without flow restricted, with grade 3 TIMI blood flow. None of the 6 patients had serious complications, and all of them were discharged from hospital after surgery. The length of hospital stay was 5-7 days. Conclusions　The combination of intravascular imaging and shockwave balloon intravascular lithotripsy can accurately evaluate and effectively deal with calcification lesions. The nursing staff should skillfully master the basic principles of intravascular imaging and shockwave balloon intravascular lithotripsy and the key points of operation cooperation, make full preoperative preparations, closely observe the changes of patients' vital signs during the operation, and take timely and effective nursing measures for possible complications, which is an important guarantee for successful operation.

Key words:

Coronary artery, Calcification, Shockwave balloon, Intravascular lithotripsy, Intravascular imaging, Nursing cooperation

于雷贾晓辉.

腔内影像联合血管内碎石术治疗冠状动脉钙化病变的护理配合 [J]. 国际医药卫生导报, 2024, 30(4): 646-650.

Yu Lei, Jia Xiaohui.

Nursing cooperation of intravascular imaging combined with shockwave balloon intravascular lithotripsy in the treatment of coronary artery calcification [J]. International Medicine and Health Guidance News, 2024, 30(4): 646-650.

参考文献

[1] «冠状动脉钙化病变诊治中国专家共识»专家组. 冠状动脉钙化病变诊治中国专家共识(2021版)[J]. 中国介入心脏病学杂志,2021,29(5):251-259. DOI:10.3969/j.issn.1004- 8812.2021.05.002.
[2] 吴永新,陈曼华. 冠状动脉内旋磨术并发无复流的研究进展[J]. 中国心血管病研究,2022,20(7):650-655. DOI:10.3969/j.issn.1672-5301.2022.07.011.
[3] Ho HH, Lee JH, Khoo DZL, et al. Shockwave intravascular lithotripsy and drug-coated balloon angioplasty in calcified coronary arteries:preliminary experience in two cases[J]. J Geriatr Cardiol, 2021, 18(8): 689-691. DOI: 10.11909/j.issn.1671-5411.2021.08.009.
[4] Wong B, El-Jack S, Newcombe R, et al. Shockwave intravascular lithotripsy for calcified coronary lesions: first real-world experience[J]. J Invasive Cardiol, 2019, 31(3): 46-48.
[5] Wong B, El-Jack S, Newcombe R, et al. Shockwave intravascular lithotripsy of calcified coronary lesions in ST-Elevation myocardial infarction: first-in-man experience[J]. J Invasive Cardiol, 2019, 31(5): E73-E75.
[6] Brinton TJ, Ali ZA, Hill JM, et al. Feasibility of shockwave coronary intravascular lithotripsy for the treatment of calcified coronary stenoses[J]. Circulation, 2019, 139(6): 834-836. DOI: 10.1161/CIRCULATIONAHA.118.036531.
[7] Ali ZA, Brinton TJ, Hill JM, et al. Optical coherence tomography characterization of coronary lithoplasty for treatment of calcified lesions: first description[J]. JACC Cardiovasc Imaging, 2017, 10(8): 897-906. DOI: 10.1016/j.jcmg.2017.05.012.
[8] Ali ZA, Nef H, Escaned J, et al. Safety and effectiveness of coronary intravascular lithotripsy for treatment of severely calcified coronary stenoses: the disrupt CAD II study[J]. Circ Cardiovasc Interv, 2019, 12(10): e008434. DOI: 10.1161/CIRCINTERVENTIONS.119.008434.
[9] Zhang M, Matsumura M, Usui E, et al. Intravascular ultrasound-derived calcium score to predict stent expansion in severely calcified lesions[J]. Circ Cardiovasc Interv, 2021, 14(10): e010296. DOI: 10.1161/CIRCINTERVENTIONS.120.010296.
[10] Fujino A, Mintz GS, Matsumura M, et al. A new optical coherence tomography-based calcium scoring system to predict stent underexpansion[J]. EuroIntervention, 2018, 13(18): e2182-e2189. DOI: 10.4244/EIJ-D-17-00962.
[11] 麦洁俭,周龙珊. 临时起搏器在急性心肌梗死合并缓慢性心律失常患者治疗中的应用效果[J/CD]. 现代医学与健康研究(电子版),2023,7(2):54-57. DOI: 10.3969/j.issn.2096- 3718.2023.02.016.
[12] Azzalini L, Bellini B, Montorfano M, et al. Intravascular lithotripsy in chronic total occlusion percutaneous coronary intervention[J]. EuroIntervention, 2019, 15(11): e1025-e1026. DOI: 10.4244/EIJ-D-19-00175.
[13] 王天杰,袁建松,张紫薇,等. 准分子激光冠状动脉内斑块消蚀术对严重钙化冠状动脉病变的治疗作用[J]. 中国分子心脏病学杂志,2021,21(4):4076-4079. DOI:10.16563/j.cnki. 1671-6272.2021.08.010.
[14] 陈建秀,李秀峰. 护理干预对经皮冠状动脉介入术患者心理状态和自我管理能力的影响[J]. 国际医药卫生导报,2019,25(8):1321-1324. DOI:10.3760/cma.j.issn.1007-1245. 2019.08.044.
[15] 刘倩倩. 个体化五行音乐疗法配合分级心理干预对心肌梗死PCI手术患者知觉压力及心境状态的干预作用[J]. 国际医药卫生导报,2021,27(20):3176-3178. DOI:10.3760/cma.j.issn.1007-1245.2021.20.015.
[16] Sucato V, Novo G, Saladino A, et al. Coronary microvascular dysfunction[J]. Minerva Cardioangiol, 2020, 68(2):153-163. DOI: 10.23736/S0026-4725.20. 05070-7.
[17] 石惠薇,刘硕霖,热娜提·肉孜,等. 冠状动脉钙化的机制研究进展[J]. 中国心血管病研究,2020,18(11):1039-1043. DOI:10.3969/j.issn.1672-5301.2020.11.016.
[18] Nakahara T, Dweck MR, Narula N,et al. Coronary artery calcification: from mechanism to molecular imaging[J]. JACC Cardiovasc Imaging, 2017, 10(5): 582-593. DOI: 10.1016/j.jcmg.2017.03.005.
[19] 李晓冉,赵笑男,陈晖. 冠状动脉钙化病变干预策略及治疗进展[J]. 中国循证心血管医学杂志,2020,12(4):509-512. DOI:10.3969/j.issn.1674-4055.2020.04.35.
[20] 吴春英. 急性心肌梗死急诊介入治疗术中的护理配合应用分析[J]. 心血管病防治知识,2018(26):79-81. DOI:10.3969/j.issn.1672-3015(x).2018.26.031.
[21] 郑佳丽,王欢欢,胡傲. 临床护理路径结合介入护理配合对经导管主动脉瓣置换术患者护理依从性的影响[J]. 国际护理学杂志,2021,40(13):2469-2471. DOI:10.3760/cma.j.cn221370-20200120-00707.

腔内影像联合血管内碎石术治疗冠状动脉钙化病变的护理配合

Nursing cooperation of intravascular imaging combined with shockwave balloon intravascular lithotripsy in the treatment of coronary artery calcification

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

[1]	童志兰廖源罗景和张金张琪媚. 联合肝脏离断和门静脉结扎二步肝切除术治疗巨大肝癌的护理配合 [J]. 国际医药卫生导报, 2024, 30(4): 666-669.
[2]	谢应业, 钟浩文, 陈丽, 章梦璧, 谢娜, 陈建华, 刘玉峰, 赖艳红, 苏晓燕. 终末期肾脏病患者冠状动脉钙化评估方法与心血管事件的关系 [J]. 国际医药卫生导报, 2022, 28(8): 1042-1046.
[3]	陈辉, 余辉. 枸橼酸钠对高磷诱导小鼠血管平滑肌细胞钙化的抑制作用及机制[J]. 国际医药卫生导报, 2021, 27(6): 861-868.