主动脉球囊反搏在冠脉搭桥术后应用的观察与护理

Observation and nursing for application of intra-aortic balloon pumping after coronary artery by- pass grafting

目的评价主动脉球囊反搏（IABP）在冠状动脉搭桥术后的作用和效果，并总结其护理要点。方法选取河南省人民医院心外科监护室2001年3月至2011年12月冠状动脉搭桥术后低心排综合征应用IABP的患者39例，通过对比IABP治疗前后的舒张压、收缩压、平均动脉压、尿量、血氧饱和度及心率，分析IABP的疗效。结果应用IABP约40min后患者的收缩压、舒张压、血氧饱和度、平均动脉压都有所提高，尿量增加、心率下降。出现穿刺点渗血、血肿3例，下肢缺血栓塞并肾缺血、肾功能衰竭1例，最终死亡6例，余32例治愈出院。结论IABP对增加冠状动脉血流、减轻心脏后负荷、改善心肌氧供、增加心输出量有显著作用，是治疗冠状动脉搭桥术后出现低心排综合征的有效手段。

Objective To evaluate the effect of intra-aortic balloon pumping （IABP） after coronary artery bypass grafting, and summarize the nursing essential. Methods Thirty-nine patients with low cardiac output syndrome after CABG were given IABP. To analyze the effect of IABP by comparing diastolic blood pressure, systolic blood pressure, mean blood pressure, urine, oxygen saturation and heart rate before and after IABP. Results About forty minutes after IABP, heart rate decreased, diastolic blood pressure, systolic blood pressure, mean blood pressure and urine increased. Some complications still existed, including three patients with hematoma in puncture site, one patient with renal failure. Finally, three patients were dead, other patients were cured. Conclusions IABP plays an important role in treating low cardiac output syndrome.