胸腔镜与正中开胸冠状动脉搭桥术后的护理比较

Comparison of nuring of thoracoscopic and median sternal incision cononary artery bypass graft operation

目的比较胸腔镜冠状动脉搭桥与正中开胸冠状动脉搭桥的术后护理方法，探讨术后护理的特点和措施。方法分析胸腔镜下冠状动脉搭桥患者57例与常规正中开胸冠状动脉搭桥缺损65例患者术后血流动力学监测、循环与呼吸系统的监护、血管活药物的应用、引流血量及术后疼痛护理等方面情况。结果胸腔镜下冠状动脉搭桥较正中开胸手术患者呼吸系统、循环系统相对稳定，而且术后用药少、拔管早、进食早、活动早、恢复快、但肺部并发症稍多。结论胸腔镜下冠状动脉搭桥较正中开胸护理相对简单，减少了工作量少，提高了护理工作效率，且患者术后创伤小，疼痛轻，恢复快，住ICU时间明显缩短。

Objective To compare nuring of thoracoscopic and median sternal incision cononary artery bypass graft （CABG） . To investigate the peculiarity of nuring after thoracoscopic CABG. Methods From April 2005 to November 2008 , 57 cases of ttloracoscopic CABG and 65 cases of median sternal incision CABG were performed in our hospital. The nuring after both type of operations, including monitoring of hemodynamics, ward of circulatory and respiratory system, using of vasoactive drugs, drainage blood volume and pain were analyzed and campared. Results The patients underwent thoracoscopic CABG had more stable circulatory and respiratory system, less using of vasoactive drugs, earlier time of extubation, eating, movement and recovery, a little more pulmonary complications than the patients underwent median sternal incision CABG. Conclusions The nuring of thoracoscopic CABG is easier, less amount of work and more efficient than those of median sternal incision CABG. The patients of thoracoscopic CABG have less trauma and pain, recover more quickly and cound leave ICU earilier.