床边紧急置入主动脉内球囊反搏治疗心源性休克的围术期护理

目的总结床边紧急置入主动脉内球囊反搏（IABP）辅助治疗急性心肌梗死合并心源性休克的围术期护理。方法对15例急性心肌梗死合并心源性休克患者床边置入IABP的围术期护理要点进行总结,包括术前准备,术中配合,术后生命体征、尿量、心电图、球囊导管、反搏压力、并发症等的监测。结果患者在应用IABP辅助治疗后,血流动力学趋于稳定,表现为心率减慢,舒张压、平均动脉压、尿量明显增加,血管活性药物剂量明显减少（P〈0.01）;住院期间存活11例,死亡4例。结论对于急性心肌梗死合并心源性休克早期床旁应用IABP的患者,积极的术中配合和有效的术后监护能为冠脉血运重建提供稳定的血流动力学支持,提高救治成功率。

Perioperative nursing of bedside emergent intra-aortic balloon pump operation for the treatment of cardiogenic shock

Objective To summarize perioperative nursing of bedside emergent intra-aortic balloon pump（IABP） for the treatment of acute myocardial infarction complicated by cardiogenic shock.Methods The perioperative nursing for 15 patients with acute myocardial infarction complicated by cardiogenic shock receiving bedside emergent IABP were summarized.The key points were preoperative preparation,intraoperative cooperation,postoperative monitoring of vital signs,urine volume, electrocardiogram,balloon catheter,counterpulsation pressure and postoperative complications.Results After IABP treatment,the patients＇ hemodynamic indexes tended to be stable,which showed decreased heart rate,increased diastolic pressure,mean arterial pressure and urinary volume,and decreased vascular active drug dose（P0.01）.Eleven out of 15 patients survived. Conclusion Active intraoperative cooperation and effective postoperative monitoring may provide hemodynamic support for coronary revascularization and improve the success rate of IABP in patients with acute myocardial infarction complicated by cardiogenic shock.