冠状动脉造影与冠心病介入性治疗并发症原因分析及护理

目的分析冠状动脉造影及冠心病介入治疗严重并发症原因、临床表现、处理,进一步改善治疗及护理对策。方法对733例冠状动脉造影及冠心病介入治疗病例回顾分析,并给予相应的护理。结果 126例发生术中及术后并发症,其中单纯冠状动脉造影发生并发症49例,PCI并发症77例。总并发症发生情况是：死亡1例;急性血管闭塞12例;快速心律失常6例;冠状动脉穿孔和心包填塞2例;造影剂过敏反应11例;股动脉穿刺局部血管并发症15例;血管迷走反射38例;低血压41例。护理干预结果除1例因急症PCI发生严重再灌注心律失常死亡外,其它并发症经医疗护理干预后均缓解痊愈。结论随着临床医生及护理经验积累,冠状动脉造影及冠心病介入治疗并发症可及时发现,正确治疗。手术的成功率及病人生存质量均可明显提高。

The Reason Analysis and Nursing of Complications Associated with Coronary Angiogtaphy and PCI

Objective To analyze the reasons and clinical presentations of complications associated with coronary angiography and percutaneous coronary intervention（PCI） and gain correct treatment and nursing strategies. Methods The complications of 733 patients undergoing coronary angiograph and PCI from April 2008 to April 2010 were analyzed retrospectively. Results 126 patients experienced various complications during and after operations totally,among which 49 patients and 77 patients occurred in coronary angiography and PCI respectively,including one case of death;12 cases with abrupt vessel closing;6 cases with tachy-arrhythmia;2 cases with coronary vessel perforation and cardiac tamponade;11 cases with allergy to contrast medium;15 cases with groin vascular complications;38 cases with vessel-vagal reflection;41 cases with hypotention. Except one case died due to serious ischemia-reperfusion arrhythmia,the others recovered completely because of appropriate treatment and nursing. Conclusion The complications associated with coronary angiography and PCI can be detected and treated in time as clinicians and nurses accumulate more experiences. The success rate of operation can be raised and the living quality of patients can be improved.