目的 探讨主动脉球囊反搏(IABP)联合冠状动脉旁路移植术(CABG)在冠脉多支病变低心输出中的应用及护理.方法 对24例左主干及冠脉多支严重病变心功能低下患者在CABG围术期行主动脉球囊反搏术,监测血流动力学指标,重视围术期重要器官支持与保护,加强IABP应用期间病情观察及并发症预防和护理.结果 24例患者在IABP术后心功能不同程度改善,表现为收缩压、平均动脉压、尿量较前明显增加、心率减慢;14例患者在IABP支持下顺利行CABG术,其余10例患者CABG术后启用IABP后血流动力学趋于稳定;球囊反博期间发生并发症7例,其中肾功能不全2例(8.3％)、穿刺部位渗血3例(12.5％)、下肢缺血2例(8.3％);20例患者术后顺利康复,4例患者因多脏器功能衰竭自动放弃治疗.结论 在左主干及冠脉多支病变的重症患者CABG围术期联合主动脉球囊反搏治疗,可有效纠正血流动力学异常,改善心功能而控制病情,严密的病情观察与行之有效的护理干预,可预防或减少并发症的发生,促进患者顺利康复.%Objective To discuss application of intra-aortic balloon pump(IABP) combined with coronary artery bypass grafts(CABG) on low cardiac output in patients with left trunk and coronary multivessel lesions and its nursing.Methods A total of 24 low cardiac output patients with left trunk and coronary multivessel lesions were given intra-aortic balloon pump,hemodynamic index was monitored,and their vital organs were supported and protected,disease observation and nursing of complications was enhanced during IABP.Results After intra-aortic balloon pump,24 patients had increased systolic pressure,average arterial pressure and urine volume,and decreased heart rate.And 14 CABG cases were smoothly performed under supporting of IABP.The remaining 10 patients had steadiness hemodynamic index after CABG,among whom 7 cases occurred complications,2 with renal insufficiency (8.3％),3 with puncture place bleeding (12.5％),and 2with lower limb ischemia.A total of 20 patients were recovered after surgery,and 4 patients gave up treatment for multiple organ failure.Conclusion CABG perioperative jointed with intra-aortic balloon pump may rectify the abnormal hemodynamics of patients with severe left trunk and coronary artery disease,improve cardiac function.Rigorous disease observation and efficient nursing intervention can decrease complications and promote the patients recovery.
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