标准化流程干预用于OPCAB术后心肺功能衰竭行ECMO支持患者的护理价值  

Nursing value of standardized process intervention on patients with cardiopulmonary failure after OPCAB undergoing ECMO support

作　　者：张婷智 李颖[1] 汪晶[1] 刘海玲[1] 马晶[1] ZHANG Tingzhi;LI Ying;WANG Jing;LIU Hailing;MA Jing(Intensive Care Medicine DepartmentⅡ,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830000,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,新疆乌鲁木齐830000

出　　处：《中国临床研究》2024年第4期644-647,共4页Chinese Journal of Clinical Research

基　　金：新疆维吾尔自治区自然科学基金资助项目(2022D01C224)。

摘　　要：目的探讨标准化流程干预对于非体外循环冠脉旁路移植术(OPCAB)术后心肺功能衰竭行体外膜肺氧合(ECMO)支持患者的护理价值。方法选取2019年5月至2022年12月新疆医科大学第一附属医院就诊的90例OPCAB术后心肺功能衰竭行ECMO支持患者为观察对象,采用分层随机化法分为观察组和对照组,各45例。对照组采用常规护理干预,观察组给予标准化流程干预。比较两组ICU时间、ICU费用、ECMO辅助时间、住院时间,对比两组干预前、干预1个月后心脏功能[欧洲心脏手术风险评估系统(EuroScore)评分]、呼吸情况[呼吸困难评分量表(DECAF)评分],记录两组并发症以及存活率。结果观察组ICU时间、住院时间和ICU费用均低于对照组(P<0.05)。干预后1个月,两组EuroScore、DECAF评分均降低,且观察组低于对照组(P<0.05);观察组并发症总发生率低于对照组(P=0.035),两组存活率差异无统计学意义(P>0.05)。结论标准化流程干预用于OPCAB术后心肺功能衰竭行ECMO支持患者,可有效缩短ICU及住院时间,减少并发症发生。Objective To explore the nursing value of standardized process intervention on patients receiving extracorporeal membrane oxygenation(ECMO)support for cardiopulmonary failure after off-pump coronary artery bypass(OPCAB).Methods A total of 90 patients with cardiopulmonary failure after OPCAB receiving ECMO support in the First Affiliated Hospital of Xinjiang Medical University from May 2019 to December 2022 were selected as observation subjects,and were divided into observation group and control group by stratified randomization method,with 45 cases in each group.The control group was given routine nursing intervention,and the observation group was given standardized process intervention.The clinical indicators(ICU stay,ICU cost,ECMO auxiliary time,hospital stay)and cardiac function(European system for cardiac operative risk evaluation,EuroScore)score and respiratory status(dyspnoea,eosinopenia,consolidation,acidemia and atrial fibrillation,DECAF)score before and 1 month after intervention were compared between two groups.Complications and survival rate were recorded in both groups.Results The ICU stay,hospital stay and ICU cost were significantly less than those in control group(P<0.05).One month after the intervention,the scores of EuroScore and DECAF in both groups were significantly decreased,and the scores in observation group were significantly lower than those in control group(P<0.05).The total incidences of complication was significantly lower in observation group than that in control group(P=0.035),but there was no statistical difference in survival between the two groups(P>0.05).Conclusion The application of standardized process intervention for patients with cardiopulmonary failure after OPCAB undergoing ECMO support can effectively shorten the ICU stay and hospital stay,and reduce the incidences of complications.

关 键 词：非体外循环冠脉旁路移植术 体外膜肺氧合 标准化流程干预 心肺功能衰竭 欧洲心脏手术风险评估系统 呼吸困难评分量表 

分 类 号：R654[医药卫生—外科学]