冠状动脉旁路移植术93例围手术期的护理

目的:探讨冠状动脉旁路移植术(coronary artery bypass grafting,CABG)围手术期的护理.方法:术前充分准备,做好心理护理和血糖、血压的监测,改善心肺功能,预防心绞痛发作,遵医嘱合理给药改善心肌缺血,保护下肢静脉;术后以维持循环稳定为主,加强呼吸道管理和呼吸支持,保持引流管通畅,同时充分镇静,监测血糖,维持水、电解质及酸碱平衡,做好饮食、营养、活动的健康指导及患肢护理等.结果:术后并发心室颤动1例,室上性心动过速8例,室性期前收缩3例,胸内出血5例,病死8例,应用主动脉球囊反搏1例,切口感染4例,下肢深静脉血栓1例;平均住院28 d.结论:术前做好充分准备,术后做好各系统的监护、引流管的护理及健康指导,可有效帮助患者安全度过围手术期.

Perioperative nursing of 93 patients with coronary artery bypass grafting

Objective:To investigate the perioperative nursing experience of patients with coronary artery bypass grafting(CABG).Methods:Psychological nursing,monitoring blood glucose and blood pressure,improving heart and lung function,preventing angina pectoris,improving myocardial ischemia and protecting lower limb vein were carefully preparated before operation.Maintaining stability of circulatory,strengthening management of respiratory tract and respiratory support and keeping drainage duct open were carried out,meanwhile keeping adequate sedation,monitoring blood glucose,maintaining the balance of water,electrolyte and acid-base,guiding diet,nutrition and nursing limb were implemented after operation.Results:The complications included ventricular fibrillation in 1 case,supraventricular heartbeat over in 8 cases,premature ventricular contraction in 3 cases,intrathoracic hemorrhage in 5 cases,death in 8 cases,counterpulsation after application of intra aortic balloon in 1 case,incision infection in 4 cases and lower extremity deep vein thrombosis in 1 case.The average hospital stay was 28 days.Conclusions:Preoperative full preparation,postoperative monitoring all system,nursing of drainage tube and good health guidance can effectively help patients through the critical time of surgery.