体外与非体外循环冠状动脉搭桥术临床对比及护理研究

Research on clinical comparison between the coronary pump artery bypass grafting and off - pump coronary artery bypass and nursing

目的观察比较体外循环冠状动脉搭桥术（CPABG）和非体外循环冠状动脉搭桥术（OPCAB）的疗效，探讨其护理措施。方法选取65例冠脉搭桥术患者，随机分为两组，33例行OPCAB，32例行CPABG，对两组患者分别行相应的护理，包括术后严密监测生命体征，严密心电监护，加强呼吸系统的监护，维持血压稳定，患肢动脉血栓预防，华法林的合理使用等，观察比较两组患者手术情况，术后恢复及心功能改善情况。结果OPCAB组患者手术时间及出血量均明显低于CPABG组，两组比较差异具有统计学意义（P〈0．05）。两组患者手术前后心功能分级，组间比较差异无统计学意义（P〉0．05）；术后与术前相比，心功能均显著改善，差异均有统计学意义（P〈0．05）。OPCAB组患者ICU留住时间，辅助呼吸时间，并发症发生情况，拔纵隔、心包引流管时间，住院时间及住院费用均明显低于CPABG组，差异均有统计学意义（P〈0．05）。结论OPCAB较CPABG治疗冠心病患者术后恢复快，疗效更为显著；护士掌握手术相关知识及护理要点，为患者提供优质高效专业的护理，是保证手术成功的关键。

Objective To observe and compare the clinical effects of in vitro and off - pump coronary artery bypass, and nursing interventions. Methods A total of 65 patients with coronary artery bypass grafting were randomly divided into two groups, 33 patients were treated with OPCAB, and 32 cases were treated with CPABG, two groups of patients adopted appropriate care, including postoperation monitoring of vital signs, strict ECG and the respiratory system, maintainance of blood pressure stabilization, limb arterial thrombosis prevention, rational use of warfarin. The two groups were compared with surgery, postoperative recovery of cardiac function. Results The operative time and bleeding volume of OPCAB group were significantly lower than those of CPABG group, the difference was statistically significant. OPCAB group of patients with ICU retain, assisted breathing time, complications, dial mediastinal pericardial drainage time, hospital stay and hospitalization costs were significantly lower than those of CPABG group, the differences were statistically significant （ P 〈 0. 05 ） . Conclusions The curative effect of OPCAB for treating the patients with coronary heart disease was better than that of CPABG. Nurses should grasp the surgery - related of knowledge and care points for patients to provide high quality and professional care.