重度慢性血栓栓塞性肺动脉高压行肺动脉内膜剥脱联合冠状动脉搭桥术后患者的护理1例  

Nursing care of a patient with severe chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy combined with coronary artery bypass grafting

作　　者：孙秀梅 保晶[1] 孙瑜 纪亚 申艳玲[1] Sun Xiumei;Bao Jing;Sun Yu;Ji Ya;Shen Yanling(Department of Surgical Intensive Care,China-Japan Friendship Hospital,Beijing 100029,China;Department of Cardiovascular Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院外科重症医学科,北京100029 [2]中日友好医院心脏血管外科,北京100029

出　　处：《中国实用护理杂志》2022年第29期2304-2309,共6页Chinese Journal of Practical Nursing

摘　　要：目的总结1例重度慢性血栓栓塞性肺动脉高压行肺动脉内膜剥脱联合冠状动脉搭桥术术后并发顽固性低氧、感染性休克和谵妄患者的护理经验。方法对中日友好医院2020年12月收治的1例重度慢性血栓栓塞性肺动脉高压的老年患者在血流动力学管理、抗凝管理、顽固性低氧及球囊肺动脉成形术的护理、感染防控、肺康复及早期功能锻炼、过渡期护理等方面实施护理措施。结果经过数次院内外多学科专家的会诊, 凝练出针对本例患者的诊疗方案, 经过个体化及全面的护理, 患者术后恢复良好, 术后57 d转回普通病房, 术后73 d顺利出院。结论针对此例患者实施个体化且全面的护理措施, 有效的改善了患者的预后, 提高了患者的生命质量。Objective To summarize the nursing experience of a patient with refractory hypoxia,septic shock and delirium after pulmonary endarterectomy combined with coronary artery bypass grafting for severe chronic thromboembolic pulmonary hypertension.Methods An elderly patient with severe chronic thromboembolic pulmonary hypertension admitted to China-Japan Friendship Hospital in December 2020 was given nursing measures in terms of hemodynamic management,anticoagulant management,nursing of intractable hypoxia and balloon pulmonary arterioplasty,infection prevention and control,lung rehabilitation,early functional exercise and transitional nursing etc.Results After multiple consultations with multidisciplinary experts inside and outside the hospital,the patient's diagnosis and treatment plan was refined.After individualized and comprehensive nursing,the patient recovered well after surgery and was transferred back to the common ward 57 days after surgery,and discharged successfully 73 days after surgery.Conclusions The individual and comprehensive nursing measures for this patient have effectively improved the prognosis of the patient and improved the quality of life of the patient.

关 键 词：肺动脉内膜剥脱术 冠状动脉搭桥术 护理 

分 类 号：R473.6[医药卫生—护理学]