冠状动脉旁路移植术同期行冠状动脉内膜剥脱术的围术期护理

Perioperative nursing on patients undertaken coronary artery bypass combined with coronary artery intima stripping procedure

目的:探讨冠状动脉旁路移植术(CABG)同期行冠状动脉内膜剥脱术(CE)的围术期护理策略。方法:2013年12月至2014年10月,CABG患者同期行CE术的共50例,术后观察指标:心理护理、血流动力学指标、抗凝监测指标等方面的围术期护理。结果:通过加强围术期护理,配合医生完成了50例患者的外科学治疗,术后存活率99.8%,共发生围术期心肌梗死2例,其中死亡1例,低氧血症1例,术后新发心房颤动11例,2例低心排出量综合征应用IABP辅助后得以好转,无短暂性脑缺血发作和脑卒中发生。结论:对于CABG术同期行内膜剥脱术治疗的患者,加强围术期护理是提高患者生存率的有效措施之一。

Objective： Attempts to find the perioperative nursing strategies of patients undergoing coronary artery bypass grafting（ CABG）. Methods： Postoperative observation： Mental nursing and intensive care of anticoagulation therapy,hemodynamic stability on 50 patients undertaken CABG and coronary artery endarterectomy（ CE） from December 2013 to October 2014. Results： Through strengthened perioperative nursing,cooperate the doctor finished the 50 cases of surgery treatment,postoperative survival rate was 98%,of these 50 patients,2 patients occurred peri-operative myocardial infarctionin and 1 died,1case suffered from hypoxemia; 11 cases suffered from postoperative atrial fibrillation; 2 patients with Low cardiac syndromewith IABP support were improved and no transient ischemic attack and stroke. Conclusion： For patients undertaken CABG with CE to strengthen perioperative nursing is one of the effective measures to improve the patients survival rate.