PDF(Pubmed)
Abstract：
BACKGROUND: Summarizing the perioperative nursing experience in the successful treatment of 4 neonates with critical pulmonary stenosis (CPS).
METHODS: Of the 4 patients, 3 had postnatal shortness of breath and varying degrees of cyanosis, aggravated by crying and noise, and 1 had no obvious shortness of breath and cyanosis. The preoperative auscultation of the precordial region could be heard 3-4/6 systolic murmur; echocardiography was diagnosed as CPS, combined with patent ductus arteriosus, right ventricular dysplasia, and severe tricuspid regurgitation. Four children were treated with prostaglandin 5 ng/(kg-min) to maintain a certain degree of pulmonary blood flow to improve hypoxemia, effectively preventing ductus arteriosus from closure, and the infusion was discontinued 2 hours prior to the operation. Three of the children required ventilator-assisted respiration to relieve severe hypoxia and correct acidosis before surgery.
METHODS: Neonatal CPS was diagnosed.
METHODS: Four neonates with rapidly developing conditions were admitted to the hospital, a multidisciplinary in-hospital consultation was organized immediately, and a multidisciplinary collaborative team was set up, consisting of medical doctors and nurses from the medical department, the neonatal intensive care unit, cardiovascular medicine, cardiac ultrasound room, anesthesiology department, and radiology and interventional medicine department. The multidisciplinary team evaluated the treatment modality of the children and finally decided to perform percutaneous balloon pulmonary valvuloplasty. The surgical team included specialists from the Department of Cardiovascular Medicine, Department of Interventional Radiology, Cardiac Ultrasound Unit, and Department of Anesthesiology.
RESULTS: All 4 neonates were successfully operated and discharged from the hospital. Multidisciplinary follow-up interventions were carried out 1 year after discharge, and the children were in good condition.
CONCLUSIONS: The specialty nursing-led multidisciplinary collaboration model significantly improves the professional competence of nurses from various specialties, promotes the integration and development of multispecialty disciplines, and provides better quality services for children, which is the key to improving the success rate of percutaneous balloon pulmonary valvuloplasty in neonates.
METHODS: Of the 4 patients, 3 had postnatal shortness of breath and varying degrees of cyanosis, aggravated by crying and noise, and 1 had no obvious shortness of breath and cyanosis. The preoperative auscultation of the precordial region could be heard 3-4/6 systolic murmur; echocardiography was diagnosed as CPS, combined with patent ductus arteriosus, right ventricular dysplasia, and severe tricuspid regurgitation. Four children were treated with prostaglandin 5 ng/(kg-min) to maintain a certain degree of pulmonary blood flow to improve hypoxemia, effectively preventing ductus arteriosus from closure, and the infusion was discontinued 2 hours prior to the operation. Three of the children required ventilator-assisted respiration to relieve severe hypoxia and correct acidosis before surgery.
METHODS: Neonatal CPS was diagnosed.
METHODS: Four neonates with rapidly developing conditions were admitted to the hospital, a multidisciplinary in-hospital consultation was organized immediately, and a multidisciplinary collaborative team was set up, consisting of medical doctors and nurses from the medical department, the neonatal intensive care unit, cardiovascular medicine, cardiac ultrasound room, anesthesiology department, and radiology and interventional medicine department. The multidisciplinary team evaluated the treatment modality of the children and finally decided to perform percutaneous balloon pulmonary valvuloplasty. The surgical team included specialists from the Department of Cardiovascular Medicine, Department of Interventional Radiology, Cardiac Ultrasound Unit, and Department of Anesthesiology.
RESULTS: All 4 neonates were successfully operated and discharged from the hospital. Multidisciplinary follow-up interventions were carried out 1 year after discharge, and the children were in good condition.
CONCLUSIONS: The specialty nursing-led multidisciplinary collaboration model significantly improves the professional competence of nurses from various specialties, promotes the integration and development of multispecialty disciplines, and provides better quality services for children, which is the key to improving the success rate of percutaneous balloon pulmonary valvuloplasty in neonates.
摘要：
背景：总结成功治疗4例危重肺狭窄（CPS）新生儿的围手术期护理经验。
方法：在4例患者中，3有出生后呼吸急促和不同程度的紫癜，因哭泣和噪音而加剧，1例无明显的呼吸急促和紫癜。术前听诊心前区可听到3-4/6收缩期杂音；超声心动图诊断为CPS，合并动脉导管未闭，右心室发育不良,和严重的三尖瓣反流。4例患儿用前列腺素5ng/(kg·min)维持一定程度的肺血流改善低氧血症,有效防止动脉导管闭合，并且在手术前2小时停止输注。其中三名儿童在手术前需要呼吸机辅助呼吸以缓解严重的缺氧并纠正酸中毒。
方法：诊断为新生儿CPS。
方法：4例病情迅速发展的新生儿入院，立即组织了一个多学科的医院会诊，成立了一个多学科合作小组，由医疗部门的医生和护士组成，新生儿重症监护病房,心血管医学,心脏超声室，麻醉科,放射学和介入医学部。多学科小组评估了儿童的治疗方式，最终决定进行经皮球囊肺动脉瓣成形术。手术团队包括心血管内科的专家，介入放射科,心脏超声组,麻醉科。
结果：4例新生儿均手术成功出院。出院后1年进行多学科随访干预，孩子们都很好。
结论:专科护理主导的多学科协作模式显著提高了各专科护士的专业能力,促进多专业学科的融合和发展，并为儿童提供更优质的服务，是提高新生儿经皮球囊肺动脉瓣成形术成功率的关键。
方法：在4例患者中，3有出生后呼吸急促和不同程度的紫癜，因哭泣和噪音而加剧，1例无明显的呼吸急促和紫癜。术前听诊心前区可听到3-4/6收缩期杂音；超声心动图诊断为CPS，合并动脉导管未闭，右心室发育不良,和严重的三尖瓣反流。4例患儿用前列腺素5ng/(kg·min)维持一定程度的肺血流改善低氧血症,有效防止动脉导管闭合，并且在手术前2小时停止输注。其中三名儿童在手术前需要呼吸机辅助呼吸以缓解严重的缺氧并纠正酸中毒。
方法：诊断为新生儿CPS。
方法：4例病情迅速发展的新生儿入院，立即组织了一个多学科的医院会诊，成立了一个多学科合作小组，由医疗部门的医生和护士组成，新生儿重症监护病房,心血管医学,心脏超声室，麻醉科,放射学和介入医学部。多学科小组评估了儿童的治疗方式，最终决定进行经皮球囊肺动脉瓣成形术。手术团队包括心血管内科的专家，介入放射科,心脏超声组,麻醉科。
结果：4例新生儿均手术成功出院。出院后1年进行多学科随访干预，孩子们都很好。
结论:专科护理主导的多学科协作模式显著提高了各专科护士的专业能力,促进多专业学科的融合和发展，并为儿童提供更优质的服务，是提高新生儿经皮球囊肺动脉瓣成形术成功率的关键。
