非体外循环与体外循环冠脉搭桥术后出入液量的对比观察与护理

Comparative observation of postoperative fluid input and output of off-- pump and conventional coronary artery bypass grafting and nursing

目的分析非体外循环下冠状动脉旁路移植术（OPCAB）和体外循环下冠状动脉旁路移植术（CCABG）术后出入液量的变化,总结术后护理经验。方法回顾性分析并比较44例OPCAB及17例CCABG手术临床资料,统计手术后出入液量的变化。结果OPCAB组术中出血量明显少于CCABG组;术后引流液量与CCABG无明显差别;OPCAB组术后输血率明显少于CCABG组。OPCAB组术中入液量明显少于CCABG组,术后当天及第1天入液量均多于CCABG组。OPCAB组术中、术后当天出液量明显少于CCABG组,而术后第1、2、3天出液量与CCABG组相当。结论OPCABG与CCABG相比,减少了术中出血,降低了术后输血率;同时术后不需要刻意利尿及补液,在出入液量护理方面有着不同于CCABG的特点。

Objective To analyze and compare the postoperative fluid input and output between off--pump coronary artery bypass grafting （OPCABG） and conventional coronary artery bypass grafting （CCABG）, and to summarize the postoperative nursing experiences. Methods From March to July of 2006, clinical information of 44 cases of OPCABG and 17 cases of CCABG were retrospectively studied, and the changes of postoperative fluid input and output of the patients were analyzed. Results The intra--operative blood loss of OPCABG was significantly lower than that of CCABG. The post--operative drainages had no significant differences between OPCABG and CCABG. The ratio of postoperative blood transfusions of OPCABG was significantly lower than that of CCABG. The intra--operative fluid input of OPCABG was less than that of CCABG, and the fluid inputs the immediate day and the first day after the operation were more than those of CCABG. The fluid outputs of OPCABG during the day when operated and the immediate day after the operation were significantly less than those of CCABG, which in the first, second and third days after the operation had no differences with those of CCABG. Conclusions OPCABG can reduce the intra--operative blood loss and decrease the ratio of postoperative blood transfusions. OPCABG has some features different from CCABG in no need for painstaking diuresis and fluid replacement after the operation, as well as the nursing of fluid input and output.