经导管左心耳封堵术围术期护理

DOI：10.3969/j．issn．1007-5062.2016.04.016

作者单位：100029首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所介入诊疗科

通信作者：黄连军，研究生导师，研究方向：心血管的影像诊断及介入治疗。E-mail：huanglianjun2008@163．com ·心血管护理·

经导管左心耳封堵术围术期护理

付佳青马萍李立黄连军

［摘要］目的：总结经导管左心耳封堵术预防心房颤动血栓栓塞患者的围术期中护理要点。方

法：查阅文献并分析护士在左心耳封堵术的护理配合中可能出现的问题，术前参加病例讨论，访视患者，

了解患者病情，做好心理护理，取得患者及家属的配合；术中备齐所需物品、急救设施。熟练掌握手术中

的每一个操作步骤，了解手术进程，与手术医生密切配合，严密监测生命体征，及时处理并发症；术后加

强穿刺部位的护理和各种并发症的观察和护理，完善出院指导，加强随访工作以确保手术取得满意效

果。结果：8例患者均被成功完成Watchman左心耳封堵系统置入，手术时间120 180（150ʃ30）min。

术中食道超声监测均提示封堵器位置良好，出院随访至今，患者无血栓栓塞及出血事件发生。结论：经

导管左心耳封堵术是我科开展的一项新技术，护士不仅要全面了解左心耳封堵治疗过程，更应将所学知

识应用于临床实践，对患者实施系统的整体护理，加强医护患关系密切合作，提高临床技能并促进患者

早日康复。

［关键词］心房颤动；血栓栓塞；左心耳封堵术；护理

［中图分类号］Ｒ54［文献标志码］A［文章编号］1007-5062（2016）04-313-04

Nursing care in perioperative period of transcatheter LAA occlusion Jiaqing Fu，Ping Ma，Li Li，Lianjun

Huang Department of Interventional Diagnosis and Treatment，Beijing Anzhen Hospital，Capital Medical Uni-

versity，Beijing Institute of Heart Lung and Blood Vessel Disease，Beijing100029，China

［Abstract］Objective：To summarize the key points of nursing care in perioperative period for patients

with atrial fibrillation and were receiving transcatheter LAA occlusion to prevent embolization．Methods：Ｒeview

articles and analyze problems those may occur in nursing cooperation of LAA occlusion．Before operation，par-

ticipate in preoperative case discussion，visit patients，assess the clinical status，provide psychological nursing

and obtain the operation of patients and relations．During operation，get requirements and emergency instruments

ready；master every treatment step of operation，follow the process，cooperate perfectly with physicians，compre-

hensive monitor vital signs，and treat complication immediately．After operation，strengthen nursing of puncture

site，monitor the occurrence of complications，perfect discharge education and follow-up care to ensure satisfacto-

ry outcomes．Ｒesults：Watchman devices have been successfully implanted in all8cases，and operation time was

120 180（150ʃ30）min．Intraoperative transesophageal echocardiography（TEE）showed the devices all well-

positioned．All cases follow-up hitherto have no thrombosis or hemorrhage events．Conclusion：Transcatheter

LAA occlusion is a new technology developed in our department．Nursing staff should not just have a compre-

hensive understanding of the process of LAA occlusion，but also apply knowledge to practice，give patients sys-

tematical，holistic nursing care，enhance the cooperation between doctor，nurse and patient，improve clinical

skills，to promote patients for early recovery．

［Keywords］Atrial fibrillation；Thromboembolism；LAA occlusion；Nursing

心房颤动患者具有较高的血栓栓塞发生风

险［1］。血栓栓塞并发症是致死、致残的重要原因。

口服抗凝药物是预防心房颤动患者血栓栓塞事件的

有效治疗方法。然而，口服抗凝药物有效治疗窗窄，

出血风险高，需长期监测国际标准化比值（INＲ）而