无创双水平正压通气在OPCAB术后低氧血症中的应用及护理体会

目的探讨无创双水平正压通气在不停跳冠状动脉旁路移植（OPCAB）术后低氧血症中的应用及护理。方法对21例拔除气管插管后出现低氧血症的OPCAB患者在第一时间予无创双水平正压通气（BIPAP）治疗,记录上机前、上机后6h的呼吸频率、心率、动脉收缩压、血氧饱和度、氧分压,对数据采用小样本的t检验。结果 21例患者上机前后两组观察指标统计学比较,P〈0.05,差异有统计学意义。结论 BIPAP的使用能有效纠正OPCAB术后出现的低氧血症,避免了气管插管带来的一系列并发症,因此对于术后已经拔除气管插管出现低氧血症的患者,建议早期应用双水平正压无创通气。

Application and nursing of noninvasive bi-level positive airway pressure ventilation in postoperative hypoxemia after OPCAB surgery

Objective To explore the application and nursing of noninvasive bi-level positive airway pressure ventilation（BIPAP） in postoperative hypoxemia of off-pump coronary artery bypass grafting（OPCAB）.Methods Noninvasive BIPAP was immediately applied to 21 OPCAB patients when they showed signs of hypoxemia after extubation.Respiratory rates 60 h before and after the treatment,heart rate,systolic arterial pressure,oxygen saturation and oxygen partial pressure were recorded.A small-sample t-test was then employed.Results The data collected before and after the treatment were compared and the difference was statistically significant（P〈0.05）.Conclusion The application of BIPAP can effectively adjust postoperative hypoxemia after OPCAB surgery and avoid a series of complications of tracheal intubation.So it is suggested that noninvasive BIPAP be used earlier to treat postoperative hypoxemia after extubation.