急性心肌梗死患者冠脉搭桥手术的护理分析

Nursing analysis of patient with acute myocardial infarction underwent coronary artery bypass surgery

总结1例因多支冠状动脉病变的急性心肌梗死患者在体外膜肺氧合治疗辅助下行冠脉搭桥术的护理经验。主要的护理要点包括:患者行冠脉搭桥术前及时评估并上机,术后对循环系统及生命体征的监测,联合应用连续肾脏替代疗法、主动脉球囊反搏的配合以及做好皮肤、气道等各方面的综合管理,防止并发症的发生。ECMO上机后患者生命体征逐渐平稳,入住重症医学科一病区第12天体外膜肺氧合机器撤机,入住第14天依次撤离呼吸机、连续肾脏替代疗法,第18天顺利由重症医学科一病区转入心外科继续治疗。

To summarize the nursing experience of a patient with acute myocardial infarction(AMI)due to multiple coronary artery lesions who underwent coronary artery bypass surgery assisted by extracorporeal membrane oxygenation(ECMO)therapy.The main nursing points include prompt assessment of patients and application of ECMO before coronary artery bypass,postoperative monitoring of the circulatory system and vital signs,combined application of continuous renal replacement therapy,application of intra-aortic balloon pump,and comprehensive management of the skin and airway to prevent complications.The patient’s vital signs gradually stabilized after the ECMO was applied,and the ECMO was withdrawn on the 12th day of admission to Ward 1 of Intensive Care Medicine.The ventilator and continuous renal replacement therapy were withdrawn sequentially on day 14 of admission.On day 18,the patient was transferred from Ward 1 of the Intensive Care Medicine Department to the Cardiac Surgery Department for furth er treatment.