重症心脏病高龄患者行主动脉内球囊反博术后并发症的护理

目的:提高重症心脏病高龄患者行IABP术后的护理质量,减少并发症发生率。方法:回顾分析69名IABP术后重症心脏病高龄患者的临床资料,着重观察:术后术侧下肢的血运、知觉、运动、皮肤温度及色泽,足背动脉搏动的情况并与对侧比较;患者穿刺部位有无出血及血肿,全身皮肤、粘膜有无出血点及淤斑;穿刺部位局部红、肿、热、痛和化脓,或表现为发热、败血症等全身感染;反搏波及IABP导管内有无血液。结果:69例主动脉球囊反博术患者置管成功率100%,34例患者发生下肢缺血、15例患者发生出血,4例患者发生感染等并发症;无一例患者发生气囊破裂的并发症。结论:IABP治疗过程中,细致的观察及护理能够减少并发症发生,减轻患者的痛苦,大大提高重症心脏病高龄患者的抢救成功率,改善患者的生命质量。

Objective:To investigate the optimal nursing care of complications after IABP procedure in elderly critical ill patients. Methods:The clinical data of 69 elderly patients undergoing IABP surgery were analyzed, with special attention to the following aspects: postprocedural local circulation, feeling, movement, local temperature, color and dorsalis pedis artery pulse of both lower extremities; whether there is hemorrhage or hematoma in the puncture site, or petechiae in the skin and mucosa in other parts of the body; whether there is local inflammation signs such as heat, pain, redness and swelling in the puncture site, or systemic inflammatory signs such as fever and septicemia; the contra-pulse wave and whether the catheters has blood. Results:The procedural success rate was 100% in all 69 patients, with 64 patients recovered and 5 dead. Lower extremity ischemia occurred in 34 patients, bleeding in 15 cases, and infection in 4 cases. There was no balloon rapture. Conclusion:In the treatment procedures using IABP, careful observation and nursing could significantly decrease the occurance of complications, alleviate the pain, eventually leading to improved successful rate and life quality in rescuing critically ill coronary artery disease patients.