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

摘要：

目的　探讨感染性心内膜炎（IE）相关肠系膜上动脉瘤（SMAA）患者围手术期护理经验。方法　选取2022年3月至2024年6月广东省人民医院收治的4例IE相关SMAA患者作为研究对象。男2例，女2例；年龄27～53（37.25±11.27）岁；体重指数14.18～18.14（16.75±1.76）kg/m²；术前美国纽约心脏病学会（NYHA）心功能分级：Ⅱ级1例、Ⅲ级1例、Ⅳ级2例。分析围手术期护理要点与措施，包括SMAA腔内治疗前病情观察、肠系膜栓塞术后护理、肠外营养支持、抗感染用药护理、心功能维护、疼痛护理、心脏手术后出血并发症观察。采用配对t检验进行统计学分析。结果　4例IE相关SMAA患者肠系膜栓塞术后病情稳定，均顺利完成心脏外科手术。机械通气时间6～19（13.25±6.29）h，ICU停留时间1～4（2.50±1.30）d，住院时间9～31（16.75±9.81）d。围手术期，SMAA破裂伴局部血肿形成、肠系膜上动脉闭塞（远端）1例；伴附壁血栓形成1例；心律失常1例；术区出血1例。4例患者经全面护理均康复出院，出院时血清白蛋白、血红蛋白水平均高于入院时［（37.30±5.96）g/L比（28.80±3.90）g/L、（104.50±10.08）g/L比（86.50±14.93）g/L］，但差异均无统计学意义（均P>0.05）。护理满意度评分96～99（97.75±1.26）分，均为满意。术后随访3～12个月，IE及SMAA均无复发。结论　熟练掌握IE相关SMAA疾病特点，围手术期采用全方位综合护理，可有效预防并发症，改善预后，促进患者康复，提高护理满意度。

关键词:

感染性心内膜炎, 肠系膜上动脉瘤, 围手术期护理