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1、应用Watchman圭寸堵系统行左心耳圭寸堵术70例的术后护理（四川省人民医院心内一科四川成都610000）【摘要】目的：总结经皮左心耳介入封堵术预防脑血管事件围手术期的护理经验。方法：回顾性分析2014年2月〜2016年6月在四川省人民医院心内科行经皮左心耳封堵术治疗的70例心房颤动患者围术期的护理情况，包括:术前准备、术中生命体征及ACT的观察、生命体征及患者综合管理、可能发生的并发症护理等护理内容。结果：1例病人左心耳发牛术中穿破，1例发牛心包填塞；1例发牛封堵器脱落。通过严密监护和有效护理
2、，67例房颤患者术后恢复良好。术后2h、24h及3d行经胸超声心动图检查，确认无心包积液或封堵器脱落等情况。术后随访3个月，2个月复查食道超声。未出现死亡（心源性或非心源性）、致死性或非致死性恶性心律失常、急性心包填塞、脑血管意外和其他需要紧急住院治疗的植入器械相关事件的MACE事件。结论：在经皮左心耳封堵术围手术期，严密观察和有效护理有助于心房颤动患者术后的恢复，为降低术后并发症和提高手术成功率提供支持。【关键词】心房颤动;经皮左心耳封堵术;护理【中图分类号】R473.6【文献标识码】B【文章编
3、号】1007-8231（2016）17-0155-02[Abstract】ObjectiveTosummarizetheleftpercutaneousinterventionalclosuretopreventtheperioperativenursingexperieneeofcerebrovascularevents.MethodsAretrospectiveanalysisinFebruary2014〜June2016insichuanprovineepeople'shospitalofl
4、eftheartsufferwithclosuretreatmentof70casesofperioperativenursinginpatientswithatrialfibrillation,including:preoperativepreparation,intraoperativevitalsignsandACTofobservation,vitalsigns,andintegratedmanagement,thepossibilityofcomplicationsinpatientsw
5、ithnursingcarecontent,etc.Results1caseleftpatientsintraoperativewearout,1caseofcardiactamponade.Closureandoneoff.Bycloselymonitoringandeffectivenursing,67casesrecoveredwellpostoperativelyinpatientswithatrialfibrillation.2h,24haftersurgeryand3dviathora
6、cicechocardiography,confirminadvertentlyfalloffpackageeffusionorclosure,andsoonandsoforth.Postoperativefollow・upof3months,2monthsreviewofultrasoundoftheesophagus・Doesnotappear(cardiacdeathorcardiac),fatalornonfatalmalignantarrhythmia,acutecardiactampo
7、nade,cerebrovascularaccidentandotherneedemergencyhospitalizationMACEeventsofimplanteddevicesrelatedevents.ConclusionLeftinpercutaneousclosureperioperative,closeobservationandeffectivenursingishelpfultotherecoveryofpostoperativeatrialfibrillation(af),i
8、nordertoreducepostoperativecomplicationsandimprovethesuccessrateofsurgery【Keywords］Atrialfibrillation;Leftpercutaneousclosure;Nursing心房颤动患者具有较高的血栓栓塞发生风险⑴。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)而导
