摘要
目的 总结非体外循环冠状动脉旁路移植术(OPCABG)期间行心室壁瘤成形术患者的围术期护理经验。方法 选取2012年1月至2015年12月首都医科大学附属北京安贞医院拟行OPCABG和左心室室壁瘤成形术的患者共98例,美国纽约心脏病学会(NYHA)心功能分级Ⅲ级86例,Ⅳ级12例。围术期给予患者全面护理,包括心理护理、心功能护理、出入量管理、恶性心律失常护理、呼吸系统护理等方面。记录患者手术相关及术后恢复情况,记录死亡发生情况,随访观察患者的心功能恢复情况。结果 全组无患者死亡。患者术后均未发生心肌梗死。术后平均呼吸机使用时间(17±4)h,重症监护病房监护时间(1.1±0.6)d,术后住院时间(12.3±1.4)d。术后随访1~4年,患者NYHA心功能均达到Ⅰ~Ⅱ级。结论 积极有效的护理使非体外循环下行心室壁瘤成形术患者的围术期生存率得以明显提升。
Objective To summarize perioperative nursing experience of patients with off-pump coronary artery bypass(OPCABG) and ventricular aneurysm surgery. Methods A total of 98 patients undergoing OPCAB and ventricular aneurysm operation were enrolled from January 2011 to December 2015 in Beijing Anzhen Hospital, Capital Medical University, New York Heart Association(NYHA) cardiac function grade Ⅲ 86 cases, grade Ⅳ 12 cases. The patients were treated with comprehensive nursing care, including mental care, cardiac function care, intake and output management, malignant arrhythmia care and respiratory care. Postoperative recovery indexes were recorded; severe complications and death were observed; heart function recovery was assessed. Results There was no operative death in the whole group. No myocardial infarction occurred after operation. The average breathing machine use time was (17±4)h; the Intensive Care Unit stay time was (1.1±0.6)d; the hospital stay time was (12.3±1.4)d. During 1-4 years of follow-up, NYHA cardiac function recovered to grade Ⅰ-Ⅱ in all patients. Conclusion Positive nursing care contributes to postoperative recovery in patients after off-pump ventricular aneurysm operation and it increases the survival rate.
作者
何媛
陈秀梅
李雪梅
He Yuan Chen Xiumei Li Xuemei(Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
出处
《中国医药》
2017年第7期1112-1114,共3页
China Medicine