787例老年患者非体外循环冠状动脉旁路术后循环、呼吸系统并发症的护理

目的：探讨60岁及以上患者非体外循环冠状动脉旁路移植术（off-pump coronary artery bypass grafting， OPCABG）术后循环、呼吸系统的护理特点。方法回顾性总结分析787例年龄在60～85岁的OPCABG患者的临床资料，对循环、呼吸系统术后常见并发症的原因及护理进行分析探讨。结果循环、呼吸系统并发症是老年患者OPCABG术后常见病，多发病。787例老年患者术后循环、呼吸系统各种并发症总发生率高达90.47%。死亡15例，死亡率为1.91%，其中术后再次开胸止血并发肾功能衰竭死亡1例，低心排量综合征死亡1例，术后顽固性心律失常死亡2例，严重肺部感染引起多脏器功能衰竭综合征死亡11例。结论老年患者OPCABG术后循环、呼吸系统并发症的护理是术后护理的重点，对于患者顺利康复起着关键性的作用。

Nursing of circulatory and pulmonary complication in 787 cases of elderly patients undergoing off-pump coronary artery bypass grafting

Objective To investigate the nursing of circulatory and pulmonary complication in patients aged 60 and above who underwent off-pump coronary artery bypass grafting（OPCABG）. Methods Clinical data of 787 patients aged 60-85 who underwent OPCABG were analysed retrospectively. We analyzed the cause and the nursing of postoperative circulatory and pulmonary complication. Results Postoperative circulatory and pulmonary complication often occurred in elder patients. The incidence of complication was 90.47% and operation mortality was 1.91% in 787 cases. There were 15 death cases,including 1 case of renal failure after reoperation due to bleeding,1 case of low cardiac output syndrome,2 cases of refractory arrhythmias and 11 cases of multiple system organ failure caused by serious pulmonary infection. Conclusion Nursing of circulatory and pulmonary complication is the key point of the OPCABG postoperative care and is very important to elderly patients’recovery.