摘要
目的监测心脏术后应用主动脉内球囊反搏(IABP)的并发症,总结护理经验,探讨基础护理和临床监护中存在的问题。方法对47例心脏外科手术患者实施IABP的病例资料进行分析,其中急性心肌梗死35例,病变在两枝以上;冠状动脉搭桥术后8例,风湿性心脏病顽固性心功能不全2例,心脏瓣膜病2例。术前置入球囊4例,术中置入球囊37例,术后监护室内置入球囊6例。结果 47例接受IABP的患者中死亡8例,其中心源性休克3例,冠状动脉搭桥术后3例,恶性心律失常2例。术后发现并发症9例,其中出血4例,球囊导管中心腔堵塞(监测动脉压力波形管道)3例,下肢动脉缺血2例。但无IABP并发症而导致的死亡病例。结论 IABP能明显改善心脏手术围术期低心排患者的血流动力学指标,选择合适的时机应用IABP,能够提高IABP的疗效,降低危重患者的死亡率;但是如何通过严密监护,早期发现并发症的发生并及时做出处理,是保证IABP达到预期作用的重要因素。
Objective To summary the monitoring and care experiences of 47 cases of cardiac surgery patients with complications of intra-aortic balloon pump （IABP） and discuss the existed problems in basic care and clinical monitoring. Methods The clinical data of 47 cardiac surgery patients with IABP were collected. Results Among them, there were 35 cases with acute myocardial infarction, 8 cases with coronary artery bypass surgery, 2 cases with rheumatic heart disease refractory heart failure, 2 cases with valvular heart disease. Balloon placement, 3 cases with pre-operative. There were 37 cases under operative and 6 cases after operation. Conclusion IABP could significantly improve hemodynamic parame- ters in cardiac surgery patients with low cardiac output during operative, right time for IABP application could improve the efficacy of IABP effect, reduce the mortality of critically ill patients. Detection complications early and deal with them timely are the way to ensure that IABP achieve the desired effect.
出处
《西部医学》
2014年第3期375-377,共3页
Medical Journal of West China
