左西孟旦联合个性化护理干预用于体外循环心脏手术临床评价

Clinical Evaluation on Levosimendan and Individualized Nursing Intervention for Cardiac Surgery with Cardiopulmonary Bypass

目的探讨左西孟旦联合个性化护理干预用于体外循环心脏手术的疗效。方法选取医院2014年11月至2016年11月行体外循环心脏手术患者110例,按随机数字表法分为观察组和对照组,各55例。对照组患者采用常规治疗+常规护理,观察组患者在此基础上于麻醉前持续24 h外周静脉滴注左西孟旦注射液0.2μg/(kg·min)。结果治疗后,两组患者左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)均显著降低,左心室射血分数(LVEF)均显著升高(P <0.05);观察组每搏输出量显著升高(P <0.05);从升主动脉开放后1 h至术后72 h,观察组各项指标的变化比对照组平稳(P <0.05);观察组术后心脏自动复跳率为83.00%,明显高于对照组的47.25%(P <0.05);对照组不良反应发生率为10.91%,与观察组的9.09%相当(P> 0.05);观察组护理总满意度为98.18%,明显高于对照组的65.45(P <0.05)。结论左西孟旦联合个性化护理干预用于体外循环心脏手术,可保护心肌,有利于术后心脏自动复跳。

Objective To investigate the effect of levosimendan combined with individualized nursing intervention for cardiac surgery with cardiopulmonary bypass.Methods Totally 110 patients undergoing heart surgery with the cardiopulmonary bypass from November 2014 to November 2016 in our hospital were randomly divided into the observation group and the control group,55 cases in each group.The patients in the control group were given routine treatment and routine nursing,on this basis,the patients in the observation group were given 0.2μg/(kg·min)Levosimendan Injection by peripheral intravenous drip 24 h before anesthesia.Results After treatment,the left ventricular end-diastolic diameter(LVEDd)and left ventricular end-systolic diameter(LVESd)in the two groups were significantly decreased,while the left ventricular ejection fraction(LVEF)in the two groups was significantly increased(P<0.05).The stroke volume(SV)in the observation group was significantly increased(P<0.05).From 1 h after aortic opening to 72 h after the operation,the changes of all indexes in the observation group were stabler than those in the control group(P<0.05).After the operation,the spontaneous recovery rate of heartbeat in the observation group was 83.00%,which was significantly higher than 47.25%in the control group(P<0.05).The incidence rate of adverse reactions in the control group was 10.91%,which was similar to 9.09%in the observation group(P >0.05),the total satisfaction rate of nursing in the observation group was 98.18%,which was significantly higher than 65.45%in the control group(P<0.05).Conclusion Levosimendan combined with individualized nursing intervention for the cardiac surgery with cardiopulmonary bypass can protect myocardium,and conducive to the spontaneous recovery of the heartbeat.