182例非体外循环冠状动脉旁路移植术的护理  

Nursing Experience of 182 Off-pump Coronary Artery Bypass Graft

作　　者：邓华梅[1] 沈会秀[1] 黄艳勤[1] 朱晓英[1] 

机构地区：[1]广东省中医院,广东广州510120

出　　处：《临床医学工程》2008年第11期46-48,共3页Clinical Medicine & Engineering

摘　　要：目的:为了提高非体外循环冠状动脉旁路移植术的护理配合技巧,本文对182例非体外循环冠状动脉旁路移植术护理经验进行了总结。方法:手术室护士术前应做好:术前心理护理,充分的物品准备;术中应熟练掌握手术步骤使配合准确,到位,要做好输液、输血的观察与核对,密切观察生命体征,保障体位安全,防止发生低体温,保护好血管桥,严格参照安全指引使用心尖吸引和心脏稳定器,认真请点器械和缝针,预防感染。结果:182例患者手术中,7例需中转在体外循环辅助下完成手术,1例体外循环插管后未开机转流,有2例患者术中发生室颤,需立即除颤。有2例患者术后因多脏器功能衰竭死亡。结论:OPCAB手术是在跳动的心脏上进行血管吻合,操作难度大,手术风险高,手术组成员必须统一认识,密切地配合,才能保障手术顺利、安全进行。Objective To summarize nursing experience of 182 Off-pump Coronary Artery Bypass Graft （OPCAB） for improves the nursing technique. Methods Operating Room nurse should think about： peri-operative psychological support and sufficient supply preparation. During the operation： keep a close watch on the infusion and transfusion, pay attention to vital signs, keep body position safe, prevent hypothermia, take vessel grafts carefully, follow the instructions of heart stabilizer mount and vacuum stabilizer, count instruments and needles seriously and prevent infection. Results In 182 cases, 7 case need transfer to On-pump assist to finish the operation; 1 case insert the cannulas, but needn＇t on-pump;2 case occur ventricular fibrillation, 2 cases died of multiple-organ failure post-operatively. Conclusion Off-pump CABG is the most difficult and complicated heart surgery. A strong team work, in which surgeons, anesthesiologists and nurses corporate smoothly, can guarantee the success of operation.

关 键 词：非体外循环冠状动脉旁路移植术 护理 

分 类 号：R473.6[医药卫生—护理学] R654.2[医药卫生—临床医学]