急性冠状动脉综合征患者行急诊冠状动脉旁路移植术围术期不适症状及并发症的护理干预  

Nursing Intervention on Perioperative Discomforts and Complications in Patients with Acute Coronary Syndrome on Emergency Coronary Artery Bypass Grafting

作　　者：李荣[1] 杨莉莉[1] 周淑英[1] 黎凤群[1] 杨丽娟[2] 凌云清[3] 

机构地区：[1]深圳市孙逸仙心血管医院护理部,广东深圳518020 [2]深圳市孙逸仙心血管医院心内科,广东深圳518020 [3]深圳市孙逸仙心血管医院心外科,广东深圳518020

出　　处：《解放军护理杂志》2010年第14期1044-1046,1058,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：深圳市科技计划局基金(200902117)

摘　　要：目的探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者行急诊冠状动脉旁路移植术(coronary arterybypass grafting,CABG)围术期的不适症状及护理干预方法。方法采用自行设计的问卷,对121例ACS行CABG患者的围术期不适症状及并发症进行调查,其中行择期CABG者98例、急诊CABG者23例。结果急诊CABG患者发生低心排出量综合征、严重心律失常、应激性胃溃疡出血及心肌梗死的比例高于择期手术者,差异有统计学意义(P<0.05或P<0.01);急诊CABG患者发生与心绞痛及术后饮食、排泄和康复活动相关的不适症状的比例均高于择期手术者,差异有统计学意义(P<0.05或P<0.01);急诊CABG患者围术期抑郁发生率及康复运动指导需求均高于择期手术者,差异有统计学意义(P<0.05或P<0.01)。结论应针对ACS患者围术期存在的并发症和不适症状,通过个性化的护理措施和心理支持减轻或缓解急诊CABG患者的不适,促进患者康复。Objective To investigate the perioperative discomforts and nursing intervention in patients with acute coronary syndrome（ACS） on emergency coronary artery bypass grafting（CABG）. Methods Of the 121 ACS patients with CABG who were investigated by a self-designed questionnaire on the discomforts and complications, 98 undergone elective CABG and 23 undergone emergency CABG. Results The ratios of low cardiac output syndrome, severe arrhythmias, stress stomach bleeding, and myocardial infarction were significantly higher in patients with emergency CABG than in patients with elective CABG （P〈0, 05 or P〈0.01）. The incidence ratios of discomforts related to preoperative angina and postoperative diet discharge and rehabilitation activity tolerance were significantly higher in patients with emergency CABG than that in patients with elective CABG（P〈0.05 or P〈0.01）. The incidence of perioperative de- pression and needs of rehabilitation guidance were significantly higher in patients with emergency CABG than in that patients with elective CABG（P〈0.05 or P〈0.01）. Conclusion In view of the perioperative complications and discomforts in ACS patients, personalized nursing intervention and psychological supporting measures should be applied to alleviate the patient＇s discomforts and promote their recovery.

关 键 词：急性冠状动脉综合征 冠状动脉旁路移植术 围术期 护理 

分 类 号：R541.4[医药卫生—心血管疾病] R473.6[医药卫生—内科学]