Abstract:

Objective　To summarize the nursing process of right ventricular dysfunction during perioperative heart transplantation and provide reference for clinical nursing. Methods　A retrospective analysis was performed on 19 patients with right ventricular dysfunction who underwent heart transplantation at the Cardiac Surgery Department of Guangdong Provincial People's Hospital from February 2023 to February 2024, including 17 males and 2 females, aged (46.2±11.0) years, 13 patients with dilated cardiomyopathy and 6 patients with ischemic cardiomyopathy. Through perioperative enhancement of right ventricular diastolic and systolic function, nitric oxide inhalation care, strengthening volume management, and improving microcirculatory perfusion, observation and care of rejection reactions, the purpose of maintaining the stability of right heart function and maintaining the effect of surgery was ultimately achieved. Results　The postoperative ventilator assistance time of the 19 patients was [28 (25, 75)]h, and the ICU stay time was (8.0±4.8) d. Conclusion　Full evaluation of patients' right ventricular function during perioperative period and optimization of perioperative right ventricular function can improve the prognosis of heart transplantation patients.

Key words:

Heart transplantation, Perioperative period, Right ventricular dysfunction, Nursing

摘要：

目的　总结心脏移植围手术期右心室功能障碍患者的护理过程，为临床护理提供参考。方法　本文为回顾性分析。选取2023年2月至2024年2月在广东省人民医院心外科行心脏移植的围手术期右心室功能障碍患者19例，其中男17例，女2例，年龄（46.2±11.0）岁，术前诊断：扩张型心肌病13例，缺血性心肌病6例。本组患者均在全身麻醉、体外循环下行同种异体原位心脏移植术。围手术期护理方法为增强右心室舒张和收缩功能、吸入一氧化氮护理、加强容量管理、改善微循环灌注、排斥反应的观察护理。结果　19例患者术后呼吸机辅助时间为［28（25，75）］h，重症监护病房停留时间为（8.0±4.8）d。结论　心脏移植围手术期应充分评估患者的右心功能，优化右心室舒张和收缩功能，可改善患者预后，提高术后存活率。

关键词:

心脏移植, 围手术期, 右心室功能障碍, 护理