持续泵入冻干重组人脑利钠肽治疗心脏术后低心排综合征的疗效观察及护理对策  

The observation of therapeutic effects of continuous pump of lyophilized recombinant human brain natriuretic peptide to treat the low cardiac output syndrome andits nursing

作　　者：姚小红[1] 蔡丽霞[1] 王广阔[1] 

机构地区：[1]广东省江门市中心医院重症医学科,江门市29000

出　　处：《护理实践与研究》2016年第2期7-9,共3页Nursing Practice and Research

摘　　要：目的：观察冻干重组人脑利钠肽治疗心脏手术后低心排综合征的疗效及护理方法。方法：选择我院2009年7～2014年10月46例确诊为体外循环心内直视手术后发生低心排综合征的患者，在常规治疗的基础上加用冻干重组人脑利钠肽，先按1．5μg／kg负荷剂量静脉注射，然后按0．015μg／（kg·min）持续静脉泵入，维持5～7d。采用治疗前后的自身对照法，观察用药前后的心率（HR）、血压（BP）、血氧饱和度（SP02）、呼吸频率（R）、每小时尿量、肺部哕音、四肢末梢温度、下肢水肿情况以及用药后5d的心脏射血分数（EF）、中心静脉压（CVP）、血浆N-末梢脑钠肽前体（NT—proBNP）、血肌酐（Ser）的变化。结果：治疗后患者肺部哕音、下肢水肿及末梢温度均有不同程度的改善，能够顺利脱离呼吸机辅助，依据疗效标准判断，显效6例，有效36例，无效4例；治疗前后比较心率、血压、血氧饱和度、呼吸频率、每小时尿量、心脏射血分数、中心静脉压、血浆N-末梢脑钠肽前体、血肌酐差异均有统计学意义（P〈0．05）。结论：持续微泵泵人冻干重组人脑利钠肽对心脏手术后发生低心排综合征的治疗有效，同时精心的护理干预对患者的康复也是非常重要的。Objective ：To observe the therapeutic effects of continuous pump of lyophilized recombinant human brain natriuretic peptide to treat the low car- diac output syndrome （LCOS） and nursing methods. Methods：Take 46 patients who were diagnosed with LCOS after the extracorporeal circulation open - heart surgery between July 2009 and Oct. 2014 as our subject and add lyophilized recombinant human brain natriuretic peptide on the basis of regular treat- ment. First use intravenous injection by 1.5 μg/kg, then keep venous bump by 0. 015 μg/（ kg · min） for 5 - 7 days. Then watch the changes of I-IR, BP, SpO2 , R, urine volume per day, lung rale, peripheral temperatures of extremities, edema of lower extremity, cardiac ejection score 5 days after the medi- cine taking, CVP, plasm N, NT - pro BNP, scr through the self - contrasted method. Results：The lung rale, edema of lower extremity and peripheral tem- peratures of extremities all get better after treatment and they could breathe on their own without breathing machine. According to the criterion of therapeuti- cal effect, we have excellent 6 cases, valid 36 cases and void 4 cases ; the differences of HR, BP, SpO~, R, urine volume per day, cardiac ejection score, CVP, plasm N, NT - pro BNP, scr have statistic meaning （ P 〈 0.05 ）. Conclusion ： The continuous pump of Lyophilized Recombinant Human Brain Natri- uretic Peptide is an effective method to treat LCOS and elaborate nursing also plays an important role in the recovery of patients.

关 键 词：冻干重组人脑利钠肽 低心排综合征 心脏手术 护理 

分 类 号：R473.6[医药卫生—护理学]