摘要
目的分析肺癌术后早期室性心律失常的危险因素,并提出相应的护理对策。方法回顾性分析521例肺癌手术患者,其中45例术后48 h内发生室性心律失常,进行多因素Logistic回归分析,并采取相应护理对策。结果本组发生术后早期室性心律失常者45例(8.6%),包括联律室性早搏、多源性室性早搏及室性心动过速等类型。患者年龄超过70岁、氧合指数<150 mm Hg、全肺切除手术、术前肺功能减退、高血压及低血钾的患者,发生术后心律失常概率明显增加;其中术前肺功能减退和全肺切除手术是术后并发室性心律失常的独立危险因素。结论术前充分评估患者全身重要器官的情况,加强患者围术期的健康教育,指导患者进行心肺功能锻炼;术后早期、充分地供氧,促进有效排痰、防止低氧血症的发生;严密进行心电监护、血气监测;及时正确地使用抗心律失常药物,落实针对性的护理措施是预防肺癌术后早期室性心律失常的有效方法。
ABSTRACT： Objective To explore the risk factors of early postoperative ventricular arrhythmias in patients with lung cancer, and to propose corresponding nursing strategies. Methods A total of 521 lung cancer patients were retrospectively studied. Among them, 45 cases occurred ventricular arrhythmias within 48 hours after operation, and were performed Logistic regression analysis, and corre-sponding nursing measures were taken. Results Postoperative early ventricular arrhythmias occurred in 45 cases（8.6% ）, including combined ventricular rhythm beats, multi -source ventricular premature beats and ventricular tachycardia speed. Patients aged more than 70 years, oxygenation index 〈 150 mmHg, total lung resection, preoperative pulmonary dysfunction, hypertension and low blood potassium were high risk factors of postoperative arrhythmia. The preoperative pulmonary dysfunction and total pneumonectomy were independent risk factors of postoperative ventricular arrhythmias. Conclusion Systemic vital organs fully should be assessed, and perioperative health education should be strengthened for patients, and cardiopulmonary exercise guidance, early postoperative sufficient oxygen supply should be conducted to promote effective expectoration and prevent the occurrence of hypoxemia. Antiarrhythmic drugs should be used timely and correctly, and nursing measures are effective methods to prevent postoperative early ventricular arrhythmia of lung cancer.
作者
杨新雅
蔡萍
YANG Xinya CAI Ping(Department of Cardiothoracic Surgery, Wuxi Fourth People＇s Hospital of Jiangnan University, Wuxi, Jiangsu, 214062)
出处
《实用临床医药杂志》
CAS
2017年第8期93-95,99,共4页
Journal of Clinical Medicine in Practice
关键词
肺癌
室性心律失常
高危因素
护理
lung cancer
ventricular arrhythmia
high risk factors
nursing
