主动脉内球囊反搏在急诊冠脉介入中应用的监测与护理

Monitoring and nursing for application of intra-aortic balloon pump surgery in emergency coronary intervention

目的探讨主动脉内球囊反搏（IABP）在急诊冠脉介入中应用的监测与护理方法。方法选取2007年10月~2010年9月我院心血管中心共应用主动脉内球囊反搏术辅助冠脉介入术后治疗的68例患者为研究对象,观察其存活率、死亡率、并发症发生率,探讨其监测和护理方法。结果所有患者均成功完成冠脉介入手术治疗,术中无死亡病例;IABP辅助治疗时间为2～10 d,平均（4.5±3.2）d;62例（91.18%）存活出院,6例（8.82%）患者死亡,3例患者于IABP辅助治疗期间出现恶性心律失常、心室颤动而死亡,3例患者于IABP撤离后发生心脏功能衰竭、多器官功能衰竭而死亡;IABP辅助治疗有效率为95.59%;IABP辅助期间发生并发症6例,并发症发生率为8.82%。结论 IABP是急诊冠脉介入治疗术后进行机械性循环支持治疗的重要方法之一,疗效较好,但并发症发生率较高,需在治疗过程中给予严密监测和护理,以提高生存率,降低死亡率。

Objective To investigate the monitoring and nursing methods for the application of intra-aortic balloon pump surgery in emergency coronary intervention.Methods 68 cases of emergency coronary intervention patients treated with intra-aortic balloon counterpulsation in the cardiovascular center of our hospital from October 2007 to September 2010 who were taken as the study objects,observed the survival rate,death rate,complication incidence and investigated its monitoring and nursing methods.Results All patients＇ coronary intervention were all successfully completed,no one was death.The IABP adjuvant therapy were given 2 to 10 days,on average（4.5±3.2） days.62 cases（91.18%） survived to hospital discharge,6 patients（8.82%） patients were dead,3 cases showed malignant arrhythmia,ventricular fibrillation and death during the IABP adjuvant therapy.3 cases occurred heart failure,multiple organ failure to death after IABP.The total effctive rate with IABP adjuvant therapy was 95.59%.During the IABP adjuvant therapy,there were 6 cases of complication,with the rate of 8.82%.Conclusion It is an important method to take intra-aortic balloon pump surgery for the emergency coronary intervention after mechanical circulatory,the clinical effect is good,but the comlication incidence is high.We have to conduct clise monitoring and nursing in the treatment course,in order to improve the suvival rate,reduce the death rate.