主动脉内球囊反搏泵使用时患者的护理措施

Analysis of the nursing measures in patients undergoing intra aortic balloon pump

目的:研究主动脉内球囊反搏泵使用时患者的护理措施。方法:选取2013年5月至2017年7月,医院收治的46例使用主动脉内球囊反搏泵救治的患者。以随机数字法分观察组(23例)和对照组(23例)。对照组给予患者普通肝素治疗联合常规护理,观察组患者给予低分子肝素治疗联合立体综合护理,对比两组患者治疗后心功能参数、血压变化,出血情况,血液检验指标。结果:术后护理干预后观察组各项心功能参数指标均高于对照组(P<0.05);治疗干预前两组患者收缩压及舒张压均差异无统计学意义(P>0.05),治疗干预后观察组患者收缩压及舒张压均高于对照组(P<0.05);护理干预后两组患者肢体缺血,缺血情况(严重与不严重)及死亡,差异均无统计学意义(P>0.05);主动脉内球囊反搏(intra-aortic balloon pump,IABP)前两组患者血色素及血小板差异无统计学意义(P>0.05),IABP后观察组血色素及血小板改善均优于对照组(P<0.05);根据Logistic回归性分析,将IABP后出血作为因变量,将其他因素作自变量,筛选出6个危险因素,即:每搏指数(SVI)、心脏指数(CI)、混合静脉血氧饱和度(SvO_2)、血压变化、血色素及血小板,差异具有统计学意义(P<0.05)。结论:IABP后出血的危险因素较多,临床治疗中应针对诸多危险因素给予积极干预,低分子肝素治疗联合立体综合护理能有效改善患者主动脉内球囊反搏泵使用时心功能及血液检验指标,同时还能有效改善患者血压,值得临床借鉴。

Objective: To study the nursing measures in patients undergoing intra aortic balloon pump. Methods: 2013,5 ~ 2017,7, there were 46 cases of patients with the use of intraaortic balloon pump for treatment. The figures were randomly divided into observation group (23 cases) and control group (23cases). The control group patients were given heparin combined with routine nursing care, observation group were treated with low molecular heparin therapy combined with comprehensive nursing, and then two groups of patients were compared after heart function parameters, blood pressure, bleeding and blood test indicators. Results: Nursing intervention of postoperative observation group after the heart function parameters was significantly higher than those in control group;the difference has no statistical significance in systolic blood pressure and diastolic blood pressure between the two groups before treatment intervention ( P >0.05);after treatment intervention, the systolic blood pressure and diastolic blood pressure of the observation group were higher than those of the control group ( P <0.05).;the difference has no statistical significance in limb ischemia, ischemic condition (severe and no serious) and death between the two groups after nursing intervention ( P >0.05);the difference has no statistical significance in intra-aortic balloon pump (IABP) in hemoglobin and platelet between the two groups ( P >0.05). The improvement of hemoglobin and platelet in the observation group after IABP was better than that in the control group ( P <0.05). According to logistic regression analysis, post-IAB hemorrhage was used as the dependent variable. Using other factors as independent variables, six risk factors were selected, namely: stroke index (SVI), cardiac index (CI), mixed venous oxygen saturation (SvO2), blood pressure changes, hemoglobin and platelets. Academic significance ( P <0.05). Conclusion: There are many risk factors for post-IABP hemorrhage. In clinical treatment, active intervention should be given for many risk factors. Low molecular weight heparin therapy combined with stereo comprehensive nursing can effectively improve the cardiac function and blood test indicators of patients with intra-aortic balloon counterpulsation pump. At the same time, it can effectively improve the blood pressure of patients, which is worthy of clinical reference.