冠状动脉造影及支架术后低血压的原因及护理对策  

Causes and Nursing Countermeasures of Hypotension after Coronary Angiography and Stenting

作　　者：蔡健爱 朱秀娴[1] 左柳 李素芬[1] 杨春萍 CAI Jian-ai;ZHU Xiu-xian;ZUO Liu;LI Su-fen;YANG Chun-ping(Department of cardiology,Zhongshan people’s hospital,Zhongshan,Guangdong 528400)

机构地区：[1]中山市人民医院心内科,广东中山528400

出　　处：《智慧健康》2020年第13期117-119,共3页Smart Healthcare

摘　　要：目的总结与分析冠心病患者行冠状动脉造影和支架植入术后发生低血压的原因及护理对策。方法回顾2017年2月至2019年3月我科进行冠状动脉造影及和支架植入的1560例冠心病患者,密切观察患者的术后表现和血压水平等,及时发现低血压,分析低血压发生的原因,给予低血压患者针对性的护理和处理。结果1560例患者中有107例患者术后发生低血压,其发生率为6.86%,低血压发生原因包括心包填塞、急性冠脉支架内血栓形成、再灌注损伤、穿刺部位出血、血容量不足、药物使用不当、迷走神经反射。及时针对低血压发生原因给予针对性处理,患者血压均恢复到术前水平或者接近术前水平。结论严重心绞痛患者、心肌梗死等冠心病患者需进行冠脉造影以及支架植入治疗,患者术后可能发生低血压,做好相关护理措施并且给予患者密切观察,在术后尽早发现患者发生低血压,给予其积极处理和护理,以减少低血压发生和避免病情加重,从而保证疗效和改善患者预后。Objective To summarize and analyze the causes and nursing countermeasures of hypotension after coronary angiography and stent implantation in patients with coronary heart disease.Methods From February 2017 to March 2019,1560 patients with coronary artery disease underwent coronary angiography and stent implantation in our department.The postoperative performance and blood pressure level of the patients were closely observed.Hypotension was detected in time,and the causes of hypotension were analyzed.Results Among the 1560 patients,107 patients had postoperative hypotension,with an incidence rate of 6.86%.The causes of hypotension included pericardial tamponade,acute coronary stent thrombosis,reperfusion injury,hemorrhage at the puncture site,insufficient blood volume,improper use of drugs,and vagal reflex.Timely targeted treatment was given for the causes of hypotension,and the blood pressure of the patients returned to the preoperative level or close to the preoperative level.Conclusion Patients with severe angina,myocardial infarction,coronary heart disease such as coronary angiography and stenting in patients need treatment,patients with postoperative hypotension may occur,close observation and related nursing measures and give patients found in patients with early postoperative hypotension,given the positive treatment and nursing,to reduce the low blood pressure and avoid illness,thus ensuring curative effect and improve patients prognosis.

关 键 词：冠心病 冠脉造影 支架植入术 低血压 护理对策 

分 类 号：R473.5[医药卫生—护理学]