Ikawati Dewi, Ganefianty Amelia, Nursiswati Nursiswati, Rahayu Urip, Kurniawan Titis, Pahria Tuti
Master Program of Nursing Universitas Padjadjaran, Bandung, Indonesia.
Hasan Sadikin Hospital, Guest Lecturer Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia.
Int Med Case Rep J. 2024 Aug 13;17:745-750. doi: 10.2147/IMCRJ.S465570. eCollection 2024.
Incessant Ventricular Tachycardia is a condition characterized by multiple episodes of Ventricular Tachycardia (VT) in 24 hours, persisting despite efforts to stop the arrhythmia. In this condition, sympathectomy as the surgical procedure is considered a permanent intervention and the last resort when medications prove ineffective. This procedure comprises the cutting or clamping of sympathetic nerves to prevent the transmission of nerve signals. Therefore, this study aims to present a case report of post-sympathectomy nursing management in a patient with Incessant Ventricular Tachycardia.
A 59-year-old female patient was admitted to the high-care unit with a diagnosis of post-sympathectomy, Incessant Ventricular Tachycardia due to Arrhythmogenic Cardiomyopathy. Nursing problems based on NANDA included decreased cardiac output, gas exchange impairment, and activity intolerance. Furthermore, the nursing interventions for the condition included self-care management and collaboration with an anesthesiologist and cardiologist. The interventions encompassed cardiac care, airway management, and activity therapy. Tele-nursing was also conducted through video calls to monitor the patient after hospital care.
The planned nursing care was effective in preventing common complications that often occur after the surgical procedure. The most important key aspect is regular maintenance and monitoring. The patient was discharged on the third day after the surgery with no complaints of shortness of breath, palpitations, and gradual resumption of activities.
Sympathectomy procedures could successfully be used to treat patients through multidisciplinary collaboration. Furthermore, nurses could emphasize post-operative care management to expedite recovery and improve patient quality of life.
持续性室性心动过速是一种以24小时内多次发作室性心动过速（VT）为特征的病症，尽管采取了措施试图终止心律失常，但仍持续发作。在这种情况下，交感神经切除术作为一种外科手术被视为一种永久性干预措施，是药物治疗无效时的最后手段。该手术包括切断或钳夹交感神经以阻止神经信号的传递。因此，本研究旨在呈现一例持续性室性心动过速患者交感神经切除术后的护理管理病例报告。
一名59岁女性患者因致心律失常性心肌病导致交感神经切除术后持续性室性心动过速入住重症监护病房。基于北美护理诊断协会（NANDA）的护理问题包括心输出量减少、气体交换受损和活动耐力下降。此外，针对该病症的护理干预包括自我护理管理以及与麻醉师和心脏病专家的协作。干预措施包括心脏护理、气道管理和活动治疗。出院后还通过视频通话进行远程护理以监测患者情况。
计划的护理措施有效地预防了手术常出现的常见并发症。最重要的关键方面是定期维护和监测。患者术后第三天出院，无呼吸急促、心悸等主诉，活动逐渐恢复。
交感神经切除术可通过多学科协作成功用于治疗患者。此外，护士可强调术后护理管理以加速康复并提高患者生活质量。
