心脏瓣膜手术后行主动脉内气囊反搏时的护理策略  

Nursing strategy of postoperative patients with intra aortic balloon pump after valve replacement

作　　者：杨丽丽[1] 刘喜梅[1] 丁艳琼[1] 

机构地区：[1]中国人民解放军总医院心血管外科,北京100853

出　　处：《中国体外循环杂志》2012年第4期221-223,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的总结主动脉内球囊反搏泵(IABP)在心脏瓣膜手术后护理策略。方法回顾2008年10月～2010年8月在体外循环下行瓣膜置换术450例患者病例,其中20例(4%)使用IABP。因术中心脏复苏后不能撤除体外循环或停机后低心排出量应用IABP 10例,术后因各种原因应用IABP 10例。对20例应用IABP的患者行护理评估,制定护理措施,进行有针对性的护理。结果全组20例患者行IABP辅助治疗时间20～120 h,平均治疗时间(53.0±28.3)h;早期存活17例(85%),死亡3例(15%),死亡原因分别为低心排出量综合征、右心衰竭及多脏器衰竭,2例出现IABP相关并发症,经处理好转。结论对心脏瓣膜手术后应用IABP的患者制定可行的护理措施,观察反搏效果,及时发现病情变化,预防各种并发症的发生,使IABP起到良好的治疗效果。Objective To summarizes the nursing strategy of patients with intra - aortic balloon counterpulsation pump （IABP） underwent heart valve replacement. Methods Among 450 patients underwent valve replacement with extracorporeal circula- tion （ECC） from Oct. 2008 to Aug. 2010, there were 20 patients needed to be applied IABP. The reasons of IABP application includ- ed unable to wean off ECC or severe postoperative low cardiac output in 10 eases, and other reasons in 10 cases. After precise nursing assessment, special nursing intervention strategies were instituted and applied to theses patients. Results The IABP insistant time of these 20 patients was 20 - 120 （53.0 ~28.3） h. Early mortality was 15% （3/20 patients）. The cause of death included low cardiac output syndrome, right heart failure and multiple organ failure. IABP related complications occurred in 2 cases. Conclusion For postoperative patients treated with IABP after valve replacement, instituting feasible nursing strategy, observing pulsation effect, timely finding the patients＂ condition change, and preventing complications are important influences on the treatment effect.

关 键 词：体外循环 心脏瓣膜病术后 主动脉内气囊反搏 护理策略 

分 类 号：R473.6[医药卫生—护理学]