冠状动脉介入治疗并发冠状动脉穿孔患者的护理

Nursing care of coronary artery perforation complicated with percutaneous coronary intervention

总结5例冠状动脉介入治疗(PCI)并发冠状动脉穿孔患者的护理经验。除加强PCI常规护理外,重点强调了血液动力学以及心肌损伤标志物和心电图变化的监测。本组3例患者并发急性心包填塞,其中2例为术后迟发性心包填塞;3例并发急性非Q 波性心肌梗死,其中1例出现心力衰竭。5例患者经积极处理,来发生Q波性心肌梗死、需紧急冠状动脉搭桥或死亡。冠状动脉穿孔是冠状动脉介入治疗少见而严重的并发症,加强术后护理对及时发现和处理各种并发症、减少不良心脏事件发生至关重要。

The authors summarized their experience in caring 5 cases of coronary artery perforation complicated with percutaneous coronary intervention （PCI）. In their practice, they stressed on the monitoring of hemodynamics, cardiac injury markers and electrocardiology, apart from routine PCI nursing care. As a result, 3 cases were complicated with acute pericardial tamponade, 2 of whom developed delayed one and 3 with non Q-wave myocardial infarction, one of whom developed cardiac failure. All the 5 cases were actively treated so that neither Q-wave myocardial infarction nor emergency bypass surgery, nor death occurred. Therefore, enhancement of postoperative nursing care and timely treatment of all complications are vital.