高龄患者冠状动脉旁路移植术后的护理

Postoperative care of older patients after coronary artery bypass grafting

总结对15例75岁及以上患者行冠状动脉旁路移植术的术后护理要点。包括呼吸道管理、神经系统观察、循环系统监护、保持血糖稳定、维持氧供与氧需的平衡、准确记录出入液量、保持引流管通常、保证营养、预防切口感染、患肢护理、功能锻炼和出院指导。15例患者痊愈出院,术后失访1例,其余14例随访6个月至2年,死亡1例,死亡原因为脑出血,其余患者无严重心脏事件发生。有针对性地做好高龄患者冠状动脉旁路移植术的术后护理,对提高手术成功率,减少并发症的发生,提高生存率具有重要意义。

This paper summarized the postoperative care of 15 patients aged over 75 years after coronary artery bypass grafting（CABG）. The key points in postoperative care were airway management,observation of neurological system,monitoring of circulation system,maintaining stable blood glucose,keeping the balance between oxygen supply and oxygen consumption, accurately recording the volume of input and output,keeping the drainage tube unobstructed,nutritional support,prevention of surgical site infection,affected limb care,functional exercises and discharge guidance. All 15 patients were discharged with recovery. Among the 14 patients who were followed up for six to 24 months,one patient died of cerebral hemorrhage,and the other patients recovered without severe cardiac events. Proper postoperative care can improve the success rate of the operation, reduce the incidence of postoperative complications and improve the survival rate of older patients after CABG.