Clinical Nursing of Heart 1: Clinical Interventional Nursing of Congenital Heart Disease
Objective: To explore the clinical interventional nursing of patients with congenital heart disease and analyze its effect. Methods: 20 12.09 ~ 20 13.09 hospitalized in our department 150 patients with congenital heart disease were selected for interventional nursing, and the effect was analyzed. Results: Through the clinical intervention and nursing of 150 patients with congenital heart disease, all patients had no complications, and the effect was particularly remarkable. Conclusion: Clinical intervention nursing for patients with congenital heart disease can greatly reduce the occurrence of complications and promote the rehabilitation of patients.
Effect analysis of interventional nursing for congenital heart disease
Congenital heart disease is a common childhood disease, among which atrial septal defect, ventricular septal defect and patent ductus arteriosus are more common. Congenital heart disease is characterized by hypoplasia and cyanosis, which can be cured by surgery. Good interventional nursing for congenital heart disease can promote the recovery of patients and reduce the probability of complications. In order to further understand the effect of interventional nursing, 150 hospitalized patients with congenital heart disease were given interventional nursing, and the effect was analyzed, which is summarized as follows.
1 data and methods
1. 1 general information
A total of 20 12.09-20 13.09 inpatients with congenital heart disease in our department were selected, including 82 female patients and 68 male patients, aged 3-50 years. Among them, there were 50 cases of ventricular septal injury, 6 cases of atrial septal injury and 39 cases of patent ductus arteriosus, all of which were diagnosed as congenital heart disease by clinical examination, electrocardiogram, chest radiograph and echocardiography, all of which met the indications of interventional treatment of congenital heart disease.
1.2 method
For children with poor tolerance and mild discomfort, general anesthesia is used, while other patients generally use local anesthesia. For patients with ventricular septal defect, atrial septal defect and patent ductus arteriosus, it is necessary to determine the size and shape of the defect by echocardiography in order to choose the appropriate occluder. The size of the occluder is appropriate, and there is no residual shunt. Release the occluder, exit the delivery system, pressurize, return to the ward, and give antibiotics to prevent infection and anticoagulation [1].
2 nursing
2. 1 preoperative care
Psychological nursing: Nurses should actively communicate with patients, patiently explain the methods, processes and advantages of interventional therapy, explain the safety and success rate of surgery, introduce successful cases of surgery to patients, establish confidence in overcoming diseases, gain trust, and eliminate concerns, so that they can receive surgical treatment in the best psychological state. For younger children, we should give them more care, increase the intimacy of nursing staff, stabilize mood swings and ensure the smooth development of preoperative preparation.
Preoperative preparation: assist in improving preoperative examination, such as blood routine, liver and kidney function, electrolyte, coagulation routine, electrocardiogram, echocardiography, chest radiograph, etc. Before operation 1 day, the patients were tested for allergy to iodine and other antibacterial drugs. Children who need general anesthesia do not cooperate. On the day of operation, children should be fasted for 4 hours and injected with 5% glucose injection to avoid hypoglycemia due to dehydration. 2 hours before operation, the skin was prepared for operation, covering both groin and perineum, observing the pulse of dorsalis pedis artery, skin temperature and color, and ensuring adequate sleep at night before operation. Patients who are nervous before operation can use sedatives, establish venous access before the patient enters the catheter room, and leave a venous indwelling needle in the left limb.
2.2 Intraoperative nursing
During the operation, nursing staff should actively assist and cooperate with doctors, understand the operation steps, and provide surgical instruments in time to be accurate. And pay attention to the patient's ECG monitoring, such as the changes of blood pressure, breathing, heart rate and other indicators, once found abnormal, immediately notify the doctor to deal with. Especially for patients under local anesthesia, it is necessary to ask and observe the physical changes of patients in time [2]. Patients who use intravenous anesthesia should pay attention to monitoring data such as oxygen saturation and ventilator, and give patients 2-4 liters of oxygen per minute.
2.3 postoperative care
2.3. 1 general care: 1 observation of vital signs: within 24 hours after operation, continue ECG monitoring, closely observe heart rate, heart rhythm and blood pressure, and pay attention to whether there are arrhythmia such as ventricular premature beats, ventricular tachycardia and sinus bradycardia. If there are, find out the reasons and deal with them. Strengthen body temperature monitoring and measure it every 4 hours. 2 Patient's posture, children under general anesthesia and unconscious children should take supine position, with their heads tilted to one side, pay attention to the child's breathing, and give oxygen when necessary. Nursing care of puncture site, closely observe whether the wound has bleeding, exudation, redness and infection. Keep the wound dry, brake the right lower limb for 6- 12h, press the vein puncture sandbag for 2h, and press the artery puncture sandbag for 4h. If the baby is restless during general anesthesia, it is easy to cause bleeding at the puncture site again. Give sedatives according to the doctor's advice. Intravenous access to guide wire, balloon and umbrella occluder in interventional diagnosis and treatment of congenital heart disease is easy to cause intimal injury and thrombosis. In addition, after the operation, the bandage is too tight and the sandbag compression time is too long, which is easy to cause thrombosis, so it is necessary to closely observe the pulse, skin temperature, color and intuition of the dorsal foot artery. To prevent necrosis caused by embolism and blood supply disorder. Observe the patient's lower limbs, and report to the doctor immediately if the skin turns pale, the skin turns cold and the arteries disappear. If the patient's pain is unbearable, sedatives can be used to make the limbs on the surgical side have good braking performance. 4 diet care: patients under general anesthesia should drink a small amount of water 2 hours after waking up, and can eat liquids such as milk after vomiting, and then gradually change to general diet. After eating, they can drink more water to promote the excretion of contrast media. If vomiting occurs, they should temporarily fast and increase glucose input to prevent hypoglycemia or dehydration. Patients under non-general anesthesia can drink water and liquid or soft food after operation, and gradually become general food, and encourage drinking more water. Pay attention to the time and quantity of urination. 6 Discharge instruction: (1) The patient insisted on taking anti-platelet aggregation drugs such as aspirin for half a year after operation. During medication, the activated thrombin time should be reviewed regularly, and the drug dosage should be adjusted according to the test results to prevent complications. (2) Within 3 months after operation, exercise properly, and don't engage in strenuous activities, so as to avoid the occluder falling off; (3) Keep warm to reduce upper respiratory tract infection; (4) Regular follow-up after discharge.
2.3.2 Observation and nursing of postoperative complications
arrhythmia
Arrhythmia is one of the most common complications after VSD occlusion. In addition to arrhythmia such as atrial premature beats and ventricular premature beats, the detachment of occluder may also cause atrioventricular block, tachycardia and ventricular fibrillation. Arrhythmia is mainly caused by the compression and traction of orbital guide wire on the edge of VSD defect and the damage of catheter to endocardium, and can also be induced by the sudden change of hemodynamics during interventional therapy [1]. Postoperative ECG monitoring should be carried out to observe the changes of heart rate and rhythm, and patrol and communication should be strengthened. If there is any abnormality, it should be reported to the doctor in time and handled. 2.3.2.2 plug falls off.
Occlusion of occluder is one of the serious complications of occlusion, which often occurs during occlusion or within 36 hours after operation. The occluder often falls off due to improper selection of lesion site or occluder size or improper operation, which can cause serious complications and even sudden death. ECG monitoring should be carried out immediately after operation, and medical staff should closely observe the changes of ECG, auscultate whether there is murmur in the heart, and pay attention to the patient's chief complaint. If unexplained dyspnea, syncope and severe arrhythmia occur after operation, we should attach great importance to it, notify the doctor in time, review the color Doppler echocardiography and determine whether the occluder falls off. If the occluder falls off, it can be taken out through cardiac catheter or emergency thoracotomy.
2.3.2.3's bleeding and hematoma
Local bleeding is also a common complication, most of which is related to insufficient local compression or short time after extubation, and a few can bleed due to inadvertent puncture. The application of anticoagulant drugs during and after operation will also increase the risk of bleeding, so nurses should closely observe whether there is bleeding, hematoma and ecchymosis at the puncture site, and change the dressing in time if it is wet. If there is bleeding at the puncture site, the puncture site should be immediately pressed 2 cm above the puncture site to stop bleeding for 20 minutes, and the elastic bandage should be bandaged again, and the limb should be braked 12 ~ 24 hours. When urinating, try to put the bedpan on the non-puncture side. If the patient has a hematoma,
2.3.2.4 thromboembolism
Interventional therapy is a percutaneous puncture operation of intravascular catheter, which is easy to cause vascular endothelial damage, and improper dressing and compression of puncture site can also cause thrombosis and embolism. Postoperative thrombosis is the main cause of cerebral infarction and other organ embolism. Therefore, patients should be given heparin sodium (saline+125mg heparin sodium solution) 24 hours after operation, 2 ~ 3ml/h for children, 5ml/h for adults and 5mg/(kg? D) oral dose [3]. After heparin saline was stopped 24 hours after operation, low molecular weight heparin 1 time/12 hours was injected subcutaneously for 3 days. However, we should closely observe the changes of bleeding time of patients, ask patients in time to prevent bleeding of gums, skin and bone mucosa caused by excessive anticoagulation, and pay special attention to the changes of patients' urine to prevent hemolysis.
2.3.2.5 hemolysis
Hemolysis is easy to occur within 24 hours after interventional therapy, mainly in patients with obvious residual shunt. The reason is that when there is residual shunt, the blood flow is not completely blocked and rubs against the patch, which causes mechanical damage to red blood cells and hemolysis. The patient will first have brown, soy sauce color or bloody urine. After operation, instruct patients to rest more and drink more water, and observe their condition. Routine urine examination was carried out for 3 days, once a day/kloc-0, and the changes of urine color, pH value and urine volume were observed. Closely observe the patient's low back pain, skin, sclera and bleeding point.
2.3.2.6 infection
Although the incision of interventional therapy is small, it is also a traumatic treatment. Routine anti-infection treatment was performed 3-5 days after operation, and the body temperature was monitored 4 times a day, and the drug could not be stopped until the body temperature was normal within 3 days. If the body temperature rises above 39℃ or the blood routine is abnormal, you should check the blood picture and blood culture in time, pay attention to heart auscultation, and take care of it according to the high fever routine.
Three results
After 150 patients with congenital heart disease were treated by clinical intervention, the auscultation murmur disappeared after operation, and there was no residual shunt by cardiac color Doppler ultrasound before discharge 48 hours after operation. All patients have no complications, and the effect is particularly remarkable.
4 discussion
Congenital heart disease is a common congenital malformation in children, and it is also the most common type of heart disease in children, and its incidence rate is slowly rising. The pathogenic factors of congenital heart disease are still unclear, and some experts believe that it is related to maternal intrauterine infection, heredity and maternal exposure to a large number of radioactive substances.
Clinical interventional nursing is a new nursing discipline in the nursing field, and it is a new nursing technology gradually formed with the popularization and development of interventional medicine. Interventional therapy of congenital heart disease is widely used because of its characteristics of less trauma, quick recovery, less pain, short hospitalization time and remarkable curative effect. Attention should be paid to preoperative nursing, psychological nursing, postoperative nursing and prevention of complications. Interventional nursing in outpatient department of congenital heart disease mainly takes modern nursing mode as the core. While nursing patients' diseases, we should also carry out nursing intervention on patients' environmental influence, psychological state and various factors that have an impact on disease rehabilitation, formulate reasonable nursing measures and procedures, and implement them correctly step by step. So as to implement it to every nursing staff and achieve the best nursing effect.
Through the analysis of the effect of interventional nursing for congenital heart disease, this group can greatly reduce the possibility of complications, improve the speed of rehabilitation, and the effect is more prominent, which promotes the rehabilitation of patients.
refer to
Ni Duanfang, Zhao Ping, Perioperative nursing of interventional therapy for congenital heart disease.
[2] Du Jie, Gao Junbi, Song Yuping, et al. Perioperative nursing experience of interventional therapy for 68 cases of congenital heart disease [J]. Nursing Practice and Research Second Half Edition, 20 10/0,7 (8): 47-49.
[3] Li Huajuan. Perioperative nursing analysis of interventional therapy for congenital heart disease [J]. Knowledge of cardiovascular disease prevention (academic edition), 2012,6 (3): 26-27.
Clinical Care of Heart II: Clinical Care of Children with Congenital Heart Disease
To explore the perioperative nursing measures for children with congenital heart disease. Through the effective improvement of cardiopulmonary function before operation, the detection of postoperative circulatory system, the management of respiratory tract and thoracic drainage tube, the children were carefully cared for to find and prevent complications in time. Results: Among the 580 patients in this group, there were 10 cases and the mortality rate was 1.72%, which effectively reduced the incidence of complications and mortality. Conclusion: Strengthening perioperative nursing is the key factor to reduce postoperative complications and mortality of children with congenital heart disease.
Congenital heart disease; Surgery; Perioperative nursing care
There are 654.38+ 10,000 ~ 654.38+05,000 cases of neonatal congenital heart disease in China every year [654.38+0]. Because of the physiological characteristics of children and the complexity of congenital heart disease, the operation is difficult, traumatic and has high complications and mortality. From September 2009 to 20 12,10,580 children with congenital heart disease received cardiac correction. After careful nursing, the complications were effectively prevented and the mortality rate was reduced. The key points of perioperative nursing are summarized as follows:
1 data and methods
1. 1 general information
Among the 580 patients in this group, there are 348 males and 232 females. The age ranged from 10 months to 14 years old. Among them, there were 265,438+00 cases of ventricular septal defect (VSD), 65,438+048 cases of atrial septal defect (ASD), 77 cases of patent ductus arteriosus (PDA), 25 cases of ventricular septal defect with patent ductus arteriosus (VSD+PDA) and 26 cases of atrial septal defect with patent ductus arteriosus (ASD+PDA). 13 cases of pulmonary hypertension), 17 cases of simple pulmonary stenosis (PS), 12 cases of simple pulmonary hypertension (pH), 4 cases of endocardial cushion defect and 3 cases of transposition of great arteries (TGA). All the children were diagnosed by ECG, color Doppler ultrasound and chest X-ray.
1.2 Nursing
1.2. 1 preoperative care
1.2. 1. 1 psychological care
Because of the trauma and risk of heart surgery, parents have great fear, and children have different degrees of emotional tension with different ages. Nurses fully understand the living habits of children, do a good job in the ideological work of children and their families, explain the surgical treatment process, and eliminate the anxiety of children and their parents.
1.2. 1.2 Enhance the body's tolerance.
Because of the poor development and resistance of children, in order to ensure the smooth operation, we should improve their physical condition, enhance their body resistance, and give them a diet with high protein, high calorie and high vitamins. Give low-flow oxygen inhalation, 3 times a day, 2 hours each time, to improve the symptoms of hypoxia and prevent colds. Patients with pulmonary infection should be actively given aerosol inhalation, expectorant and antibiotic treatment. Patients with pulmonary hypertension should closely observe the changes of their condition. Teach some older children to cooperate (including breathing and coughing, etc. ) in order to better cooperate with their work after surgery.
1.2. 1.3 Preoperative basic preparation
Pay attention to keep the skin of the operation site clean and give a full-body shower, but be careful not to catch cold to prevent incision infection; Soap water enema 1 night before operation 1 time; Do a good job in allergy tests of various drugs. Before the operation, the child should prepare a suitable anesthesia bed, put the ventilator, sputum aspirator, ECG monitor and other instruments in a waiting state, and create a suitable ward environment.
1.2.2 postoperative care
Observation 1.2.2. 1
The vital signs, central venous pressure, urine volume, skin color, temperature, humidity and arterial fluctuation should be closely observed after operation. All kinds of catheters should be fixed to ensure smooth flow, and the joints should not slip and pull out. Record the color, nature and quantity of various drainage fluids. All kinds of special drug input pipes need to be marked at the joint; 8 h after operation, the thoracic drainage tube was squeezed 1 time, each time 15 ~ 30 minutes, and the drainage volume was 400~500 ml at 5 h < 100 ml at 24 h. Report to the doctor immediately if any abnormality was found.
1.2.2.2 Maintain the acid-base balance of body fluid electrolytes.
Electrolyte 1 time was detected 4 ~ 6 h after operation, and the principle of potassium supplementation was strictly observed. The maximum amount of potassium supplementation per hour was not more than 0.3 mmol/kg. It is best to use infusion pump or micropump for fluid replacement. Record 24-hour water inflow and outflow and vital signs.
1.2.2.3 detection of circulating system
① ECG monitoring and intracardiac manometer detection. Closely observe the changes of heart rate and rhythm of children, pay attention to the changes of electrocardiogram and record them in detail, pay attention to whether there is ectopic rhythm, and prepare antiarrhythmic drugs. Continuous detection of arterial blood pressure, pressure and waveform of left atrium, right atrium and pulmonary artery. Use 500 ml of 5% glucose solution and 500 U heparin, and rinse continuously at a speed of 2 ml/h to ensure the patency of pressure taps, and air and blood clots are strictly prohibited. ② Nursing care of low cardiac output. The changes of cardiac output, central venous pressure and left atrial pressure were closely observed. Effective Indication for Observing Cardiac Output: Is the leg skin cool? Temperature difference? Plane variation. When the cardiac output improves, the temperature difference plane of leg skin moves down to the toe and stops disappearing. At this time, the foot warms, the skin color is reddish, the dorsal vein of the foot expands and fills, and the artery is easy to reach again [3-4]. ③ Nursing care of acute pericardial tamponade. The clinical manifestations are continuous increase of chest tube bleeding, sudden termination of bleeding, heart failure, decreased cardiac output, such as tachycardia, jugular vein dilatation, increased central venous pressure, decreased arterial pressure and pulse pressure, pale face, cyanosis around, decreased urine volume and even anuria. In order to make a definite diagnosis, doctors should be assisted in pericardiocentesis or pericardiotomy as soon as possible to remove blood clots, stop bleeding and relieve oppression. 1 case occurred in this group and was cured by timely treatment.
Two results
In this group, the postoperative ICU stay was 0.5 ~ 23.0 d, and 10 cases died, with a mortality rate of 1.72%. Among them, 4 cases died of low cardiac output syndrome, 2 cases of severe lung infection, 2 cases of multiple organ failure and 2 cases of pericardial tamponade. Everyone else recovered and was discharged. 1 case of pericardial tamponade caused by postoperative massive thoracic hemorrhage was cured after timely second thoracotomy to stop bleeding.
3 discussion
With the expansion of surgical indications for congenital heart disease and the improvement of surgical difficulty, patients are getting younger and younger, their condition is getting worse and worse, and the requirements for perioperative nursing level are getting higher and higher. Good perioperative nursing can effectively reduce the mortality rate of postoperative children.
References:
[1] Wu Yang. Perioperative nursing care of children with congenital heart disease [J]. Jilin Medicine, 2006,27 (6): 639.
[2] Zhu Jihua, Yang Shujuan and Fu Zang. Postoperative care of 30 cases of low-weight critical congenital heart disease [J]. Chinese Journal of Nursing, 2006,465,438+0 (3): 237-238.
Wang. Congenital heart disease in children [M]. Beijing: Beijing Publishing House, 1996: 95.
[4] Guan, He, He, et al. Perioperative nursing of non-cyanotic congenital heart disease [J]. Modern Nursing, 2008, 14 (4): 508-509.
Clinical nursing of heart Part III: Clinical nursing of rheumatic heart disease
Objective To explore the clinical nursing methods for patients with rheumatic heart disease. Methods The control group was given routine care, while the experimental group was given holistic care on the basis of routine care, and the nursing effects of the two groups were compared and analyzed. Results The scores of sleep, appetite, exercise and self-care ability in the experimental group were higher than those in the control group, and the difference between the two groups was statistically significant (P < 0.01). The satisfaction of patients in the experimental group and the control group were 97.30% and 77.78% respectively, and the satisfaction of patients in the experimental group was significantly higher than that in the control group, with statistical significance (P
Rheumatic heart disease; Holistic nursing; Quality of life; degree of satisfaction
Rheumatic heart disease is a common disease in clinical medicine, with complicated condition, long course and different symptoms. At present, rheumatic heart disease accounts for about 25% of cardiac surgery diseases in China, and its incidence is also increasing gradually, which has a great impact on patients' physical and mental health and daily life, and should be highly valued. In June 2002, 5438+065438+2065438+ 10, some patients with rheumatic heart disease were given holistic care, and the nursing effect was obvious. The report is as follows.
1 data and methods
1. 1 general data 73 patients with rheumatic heart disease admitted to our hospital in 2009110 201210 were selected as the research objects. All patients were diagnosed as rheumatic heart disease by X-ray, two-dimensional UCG and electrocardiogram, and 73 patients were randomly divided into experimental group and control group. Experimental group: 37 cases, male 17 cases, female 20 cases; The age was 33-8 1 year, with an average of (4 1.52? 12.37) years old; The course of disease was 10 months-17 years, with an average of (10.24? 2. 16) year. Control group: 36 cases, male 15 cases and female 2 1 case; Age 35-82 years old, average (42.36? 12.6 1) years old; The course of disease was 1 1 month-18 years, with an average of (10.33? 2.25 years. There was no significant difference in sex, age and course of disease between the two groups (P & gt0.05), which was comparable.
1.2 nursing methods the control group was given routine nursing, that is, the patients were told to stay in bed, and the patients were instructed to turn over and exercise regularly, so as to reduce or avoid the occurrence of various complications such as fall pneumonia. At the same time, it is necessary to strengthen the cold-proof and warm-keeping work, avoid upper respiratory tract infection caused by colds, guide patients to eat scientifically, and choose digestible and nutritious foods as much as possible. The experimental group was given holistic nursing on the basis of routine nursing, and its nursing methods included condition observation, psychological nursing, oxygen inhalation nursing and infusion nursing.
1.3 statistical methods SPSS 12.0 software was used for statistical analysis in this study, data selection (s) was used for representation, and t test was used for comparison between groups, P.
Two results
2. 1 Quality of life score Compared with the control group, the scores of sleep, appetite, exercise status and self-care ability in the experimental group are higher, and the difference between the two groups is obvious, with statistical significance (P < 0.0 1), as shown in table 1.
3 discussion
Rheumatic heart disease is usually caused by rheumatic fever activity, that is, patients have severe rheumatic fever activity, which leads to heart disease and acute rheumatic carditis. Rheumatic heart disease is more common in winter and spring, which is related to humid or cold environment. For patients with rheumatic heart disease, besides symptomatic treatment, nursing should be strengthened. Active and effective nursing is an important guarantee for the treatment of patients with rheumatic heart disease, and holistic nursing can improve the quality of life and satisfaction of patients. Holistic care for patients with rheumatic heart disease mainly includes the following points:
3. 1 Weakness of observation, shortness of breath and palpitation are common clinical symptoms in patients with rheumatic heart disease. In this regard, nurses need to strengthen the observation of the condition and judge whether the patient has symptoms such as tachycardia, abnormal pulse and dyspnea. If the above symptoms appear, you need to inform the attending doctor in time and treat the symptoms in time [1]. For patients with rheumatic heart disease, atrial contractility is obviously reduced at night, heart rate is seriously slowed down, atrioventricular conduction is blocked, and atrial refractory period is gradually shortened. Therefore, nurses need to strengthen night observation.
3.2 Psychological nursing Rheumatic heart disease has the characteristics of long course, easy repetition and great influence on life. Patients are prone to unhealthy psychology, lack confidence in treatment, and passively cooperate with treatment, which is not conducive to disease treatment. In this regard, nurses need to strengthen psychological care, give targeted psychological counseling according to the actual situation of patients, encourage and comfort patients, and introduce relevant disease treatment methods to patients, so that patients can deepen their understanding of diseases and consciously cooperate with various operations. At the same time, we should also introduce successful cases of disease treatment to patients to improve their confidence in treatment [2]. Nurses should try their best to meet the reasonable needs of patients, make them feel respected, meet their mental needs and relieve their mental stress.
3.3 Oxygen inhalation nursing hypoxia is a common symptom in patients with rheumatic heart disease. When patients have severe heart failure, obvious symptoms of hypoxia may appear, and nurses should implement nasal catheter oxygen supply in time; If the patient has pulmonary edema at the same time, appropriate amount of alcohol can be added to the humidification bottle to make it inhale effectively during oxygen supply; If the patient has chronic hypoxia symptoms for a long time, he needs to continue to take oxygen at a low flow rate, about 1L per minute; If the patient has severe symptoms of hypoxia, but no symptoms of carbon dioxide retention, he can be given large-flow oxygen inhalation intermittently, about 5L[3] per minute.
3.4 Infusion Nursing Patients with rheumatic heart disease often need infusion therapy, and nursing staff should pay attention to controlling the dripping speed. If the patient has no symptoms of heart failure, the dripping speed can be controlled at about 70 drops/minute; If the patient has symptoms of heart failure, the dripping speed can be controlled at about 20 drops/minute [4]. Pay attention to the changes of patients' vital signs during infusion.
refer to
[1] Zheng Yuexing, Chen Xiaoyan. Nursing intervention of perioperative anxiety state of rheumatic heart disease [J]. Modern Hospital, 20 10, 10 (4):11-165438.
[2] Hua Jinchang, Zheng Xiaohua, a native of Li Weiling. Effect of family nursing intervention on improving the quality of life of patients undergoing rheumatic heart valve replacement [J]. journal of nursing administration, 2009,9 (2):18-19.
It's cloudy Perioperative nursing care of 46 patients with rheumatic heart disease undergoing valve replacement [J]. China Journal of Misdiagnosis, September 2009 (26): 6461-6462.
[4] Wang Yanhong. Nursing care of elderly patients with rheumatic heart disease complicated with pulmonary infection [J]. China New Technology and New Products, 20 10, 23 (23): 22-24.
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