中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2013年
13期
1531-1533
,共3页
石丽%霍春颖%刘加林%李庆印
石麗%霍春穎%劉加林%李慶印
석려%곽춘영%류가림%리경인
主动脉内球囊反搏%体外膜肺氧合%护理
主動脈內毬囊反搏%體外膜肺氧閤%護理
주동맥내구낭반박%체외막폐양합%호리
Intra-aortic balloon counter-pulsation%Extracorporeal membrane oxygenation%Nursing
目的 总结应用主动脉内球囊反搏(IABP)联合体外膜肺氧合(ECMO)辅助治疗成人心脏术后低心排综合征的护理经验.方法 回顾性分析14例成人心脏术后患者行IABP联合ECMO辅助治疗的临床及护理资料,通过观察辅助治疗前后血流动力学变化,评价辅助效果,总结护理经验.结果 联合辅助后患者血流动力学指标较治疗前显著改善[SBP:(110.8±11.8)mm Hg/(76.7±18.1)mm Hg;DBP:(60.3±11.2) mm Hg/(48.5 ±9.5) mm Hg;LVEF:(0.48±0.02) mm Hg/(0.30±0.02) mm Hg],差异有统计学意义(t值分别为-5.732,-3.449,-6.192；P＜0.05)；患者动脉血气指标显著改善[pH:(7.39±0.18)/(7.28±0.08)；PaO2:(132.02±27.96) mm Hg/(82.71±28.32)mm Hg],差异有统计学意义(t值分别为-2.650,-3.690；P＜0.05),24 h尿量显著增加[(2 588.5±1 360.82) ml/(1 254.17±861.19) ml],差异有统计学意义(t=-3.419,P＜0.05).9例患者顺利出院.结论 IABP联合ECMO联合辅助为成人心脏术后低心排综合征的救治提供了新方法.在护理过程中严密监测、及时调整护理措施是提高救治成功率的重要环节.
目的 總結應用主動脈內毬囊反搏(IABP)聯閤體外膜肺氧閤(ECMO)輔助治療成人心髒術後低心排綜閤徵的護理經驗.方法 迴顧性分析14例成人心髒術後患者行IABP聯閤ECMO輔助治療的臨床及護理資料,通過觀察輔助治療前後血流動力學變化,評價輔助效果,總結護理經驗.結果 聯閤輔助後患者血流動力學指標較治療前顯著改善[SBP:(110.8±11.8)mm Hg/(76.7±18.1)mm Hg;DBP:(60.3±11.2) mm Hg/(48.5 ±9.5) mm Hg;LVEF:(0.48±0.02) mm Hg/(0.30±0.02) mm Hg],差異有統計學意義(t值分彆為-5.732,-3.449,-6.192；P＜0.05)；患者動脈血氣指標顯著改善[pH:(7.39±0.18)/(7.28±0.08)；PaO2:(132.02±27.96) mm Hg/(82.71±28.32)mm Hg],差異有統計學意義(t值分彆為-2.650,-3.690；P＜0.05),24 h尿量顯著增加[(2 588.5±1 360.82) ml/(1 254.17±861.19) ml],差異有統計學意義(t=-3.419,P＜0.05).9例患者順利齣院.結論 IABP聯閤ECMO聯閤輔助為成人心髒術後低心排綜閤徵的救治提供瞭新方法.在護理過程中嚴密鑑測、及時調整護理措施是提高救治成功率的重要環節.
목적 총결응용주동맥내구낭반박(IABP)연합체외막폐양합(ECMO)보조치료성인심장술후저심배종합정적호리경험.방법 회고성분석14례성인심장술후환자행IABP연합ECMO보조치료적림상급호리자료,통과관찰보조치료전후혈류동역학변화,평개보조효과,총결호리경험.결과 연합보조후환자혈류동역학지표교치료전현저개선[SBP:(110.8±11.8)mm Hg/(76.7±18.1)mm Hg;DBP:(60.3±11.2) mm Hg/(48.5 ±9.5) mm Hg;LVEF:(0.48±0.02) mm Hg/(0.30±0.02) mm Hg],차이유통계학의의(t치분별위-5.732,-3.449,-6.192；P＜0.05)；환자동맥혈기지표현저개선[pH:(7.39±0.18)/(7.28±0.08)；PaO2:(132.02±27.96) mm Hg/(82.71±28.32)mm Hg],차이유통계학의의(t치분별위-2.650,-3.690；P＜0.05),24 h뇨량현저증가[(2 588.5±1 360.82) ml/(1 254.17±861.19) ml],차이유통계학의의(t=-3.419,P＜0.05).9례환자순리출원.결론 IABP연합ECMO연합보조위성인심장술후저심배종합정적구치제공료신방법.재호리과정중엄밀감측、급시조정호리조시시제고구치성공솔적중요배절.
Objective To summarize the nursing experience of using intra-aortic balloon counterpulsation (IABP)and extracorporeal membrane oxygenation (ECMO) for patients with low cardiac output syndrome after cardiac surgery.Methods Fourteen patients with postoperative low cardiac output syndrome were treated with IABP and ECMO,and clinical and nursing data was retrospectively analyzed.By observing changes of the parameters of hemodynamics before and after,treatment effect was evaluated and nursing experience was summarized.Results Parameters of hemodynamics improved significantly after combined treatment [SBP:(110.8 ± 11.8) mm Hg / (76.7 ± 18.1) mm Hg; DBP:(60.3 ± 11.2) mmHg / (48.5 ±9.5) mm Hg; LVEF:(0.48 ± 0.02) mmHg / (0.30 ± 0.02)mm Hg],and the differences were statistically significant(t =-5.732,-3.449,-6.192,respectively ;P ＜ 0.05).Index of arterial blood gas also improved [pH:(7.39 ± 0.18) / (7.28 ± 0.08) ; PaO2:(132.02 ± 27.96) mm Hg / (82.71 ± 28.32) mm Hg],and the differences were statistically significant (t =-2.650,-3.690,respectively; P ＜ 0.05).Urine volume with 24 h increased from (1 254.17 ±861.19) ml to(2 588.5 ± 1 360.82) ml,and the difference was statistically significant (t =-3.419,P ＜ 0.05).9 patients were discharged from hospital smoothly.Conclusions IABP combined with ECMO treatment provides an effective option to rescuer patients with low cardiac output syndrome after cardiac operation.Strict monitoring and in-time adjustment of nursing methods are important steps during nursing process.
