7例侵入性心肺运动试验患者的护理
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摘要
总结侵入性心肺运动试验的操作配合要点,以期为临床护理提供借鉴。所有患者均因不明原因的呼吸困难行侵入性心肺运动试验,护理要点:(1)检查前核查关键检查结果,充分评估活动耐力,协助运动方案的优化设置;(2)检查中加强导管管理,避免并发症;(3)明确分工,合理摆放各种仪器和急救物品,保证急救及时到位;(4)进行全程心理护理,增加安全感,舒缓紧张情绪;(5)检查后关注运动氧化应激,控制输液速度,避免心律失常、心力衰竭等并发症。检查后发现有3例患者为运动诱发肺动脉高压,1例为代谢功能障碍导致呼吸困难,其余患者结果无异常。检查过程中1例发生肺栓塞,1例于检查后发生心律失常,其余患者均顺利完成检查。
This article explored key points of operative cooperation and nursing for invasive cardiopulmonary exercise test and provided reference for clinical nursing practice. All patients underwent invasive cardiopulmonary exercise tests due to unknown causes of dyspnea. Key points of nursing included:check the key test results before the examination,fully evaluate activity endurance,and assist the optimization of the exercise program,strength catheter management during the examination to avoid postoperative complications,make clear of division of labor,properly arrange and place all kinds of instruments and first-aid items to ensure timely first-aid,perform whole-procedure psychological care to improve sense of safety and relieve anxiety,pay attention to exercise-induced oxidative stress after examination,control speed of infusion to avoid complications such as arrhythmia and heart failure.Three patients were found to have exercise-induced pulmonary hypertension,1 patient had metabolic dysfunction,while the rest of 3 patients had no abnormal results. During the examination,1 patient developed pulmonary embolism,1 patient developed arrhythmia after the examination,and the rest successfully completed the examination.
This article explored key points of operative cooperation and nursing for invasive cardiopulmonary exercise test and provided reference for clinical nursing practice. All patients underwent invasive cardiopulmonary exercise tests due to unknown causes of dyspnea. Key points of nursing included:check the key test results before the examination,fully evaluate activity endurance,and assist the optimization of the exercise program,strength catheter management during the examination to avoid postoperative complications,make clear of division of labor,properly arrange and place all kinds of instruments and first-aid items to ensure timely first-aid,perform whole-procedure psychological care to improve sense of safety and relieve anxiety,pay attention to exercise-induced oxidative stress after examination,control speed of infusion to avoid complications such as arrhythmia and heart failure.Three patients were found to have exercise-induced pulmonary hypertension,1 patient had metabolic dysfunction,while the rest of 3 patients had no abnormal results. During the examination,1 patient developed pulmonary embolism,1 patient developed arrhythmia after the examination,and the rest successfully completed the examination.
引文
[1]Huang W,Resch S,Oliveira RK,et al.Invasive cardiopulmonary exercise testing in the evaluation of unexplained dyspnea:insights from a multidisciplinary dyspnea center[J].Eur J Prev Cardiol,2017,24(11):1190-1199.
[2]Maron BA,Cockrill BA,Waxman AB,et al.The invasive cardiopulmonary exercise test[J].Circulation,2013,127(10):1157-1164.
[3]Sun XG,Hansen JE,Beshai JF,et al.Oscillatory breathing and exercise gas exchange abnormalities prognosticate early mortality and morbidity in heart failure[J].J Am Coll Cardiol,2010,55(17):1814-1823.
[4]Berry NC,Manyoo A,Oldham WM,et al.Protocol for exercise hemodynamic assessment:performing an invasive cardiopulmonary exercise test in clinical practice[J].Pulm Circ,2015,5(4):610-618.
[5]Tanaka H,Monahan KD,Seals DR.Age-predicted maximal heart rate revisited[J].J Am Coll Cardiol,2001,37(1):153-156.
[6]Malik N,Claus PL,Illman JE,et al.Air embolism:diagnosis and management[J].Future Cardiol,2017,13(4):365-378.
[7]杨红梅.介入手术病人全程心理护理的探讨[J].护士进修杂志,2002,(5):381-382.
[8]许波,孙悦华.下肢动脉硬化闭塞症患者介入手术前情绪状态及原因的调查研究[J].中华护理杂志,2015,50(3):4022-4025.
[9]刘萍,黄敏贞,辜雄军.手术室医护人员使用正性暗示语言的效果研究[J].中华护理杂志,2011,46(5):482-484.
[10]杨毅,杨阳.不同强度耐力运动对大鼠心肌的氧化损伤效应[J].实验动物科学,2015,32(1):30-33.
[11]毛文星,李冰,王志梅,等.氧化应激、血管内皮功能障碍与高血压[J].现代生物医学进展,2014,14(19):3770-3774.
[2]Maron BA,Cockrill BA,Waxman AB,et al.The invasive cardiopulmonary exercise test[J].Circulation,2013,127(10):1157-1164.
[3]Sun XG,Hansen JE,Beshai JF,et al.Oscillatory breathing and exercise gas exchange abnormalities prognosticate early mortality and morbidity in heart failure[J].J Am Coll Cardiol,2010,55(17):1814-1823.
[4]Berry NC,Manyoo A,Oldham WM,et al.Protocol for exercise hemodynamic assessment:performing an invasive cardiopulmonary exercise test in clinical practice[J].Pulm Circ,2015,5(4):610-618.
[5]Tanaka H,Monahan KD,Seals DR.Age-predicted maximal heart rate revisited[J].J Am Coll Cardiol,2001,37(1):153-156.
[6]Malik N,Claus PL,Illman JE,et al.Air embolism:diagnosis and management[J].Future Cardiol,2017,13(4):365-378.
[7]杨红梅.介入手术病人全程心理护理的探讨[J].护士进修杂志,2002,(5):381-382.
[8]许波,孙悦华.下肢动脉硬化闭塞症患者介入手术前情绪状态及原因的调查研究[J].中华护理杂志,2015,50(3):4022-4025.
[9]刘萍,黄敏贞,辜雄军.手术室医护人员使用正性暗示语言的效果研究[J].中华护理杂志,2011,46(5):482-484.
[10]杨毅,杨阳.不同强度耐力运动对大鼠心肌的氧化损伤效应[J].实验动物科学,2015,32(1):30-33.
[11]毛文星,李冰,王志梅,等.氧化应激、血管内皮功能障碍与高血压[J].现代生物医学进展,2014,14(19):3770-3774.