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CHC2017：搭桥术后 IABP 护理专家共识发布

2017-08-14 刘庚 中国循环杂志

搭桥术后IABP护理专家共识
关注

为进一步规范搭桥（CABG）术后置入IABP的护理工作，我国首部《冠状动脉旁路移植术后置入主动脉内球囊反搏护理专家共识》在中国心脏大会期间的护理论坛上发布。

为进一步规范搭桥（CABG）术后置入IABP的护理工作，我国首部《冠状动脉旁路移植术后置入主动脉内球囊反搏护理专家共识》在中国心脏大会期间的护理论坛上发布。

该指南由国家心血管病中心、中国医学科学院护理理论与实践研究中心和中华护理学会重症专业委员会共同组织，在全国选取具有代表性的24位心血管外科ICU医疗和护理专家组成专家组进行编写，编写过程历时近1年，旨在提供CABG 术后置入IABP护理规范，指导最佳临床实践。

IABP 置入前

评估 IABP 置入的适应证和禁忌证、有无增加置入并发症的相关危险因素、是否有肝素诱导血小板减少症抗体阳性；所有患者和/或家属均应完成医疗机构规定的知情同意程序和文件等。
置入IABP过程

操作前准备；配合站位；IABP操作流程（置管、连接、导管位置确认、转运）规范等。

术后监测管理与实践指导

保证IABP有效触发；持续监测反搏效果，每小时记录观察指标；IABP管路管理；抗凝管理；预防感染等。

并发症观察护理

监测IABP装置工作情况和反搏波形；加强对应用鞘管穿刺法置入IABP的患者下肢血运的观察；随时监测IABP置入穿刺处情况，准确记录评估；评估双侧下肢循环；若提示球囊破裂，立即停止反搏并通知医生；协助患者早期进行双下肢的功能锻炼等。

撤除IABP的护理配合

撤机前护士主要评估指标；撤除IABP后的评估时机和指标；穿刺处伤口的管理；主动和被动活动双下肢等。


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评论区 (6)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1844800, encodeId=4fd3184480059, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Mar 15 04:31:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049821, encodeId=66ac2049821ed, content=<a href='/topic/show?id=4a5f1e68a9' target=_blank style='color:#2F92EE;'>#ABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1768, encryptionId=4a5f1e68a9, topicName=ABP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Tue Jan 16 08:31:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663906, encodeId=6d621663906dd, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Wed Aug 23 18:31:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492361, encodeId=aef0149236132, content=<a href='/topic/show?id=a251569194f' target=_blank style='color:#2F92EE;'>#搭桥术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56919, encryptionId=a251569194f, topicName=搭桥术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32a28924986, createdName=zzc2214, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552137, encodeId=5505155213e05, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615308, encodeId=86761615308c5, content=<a href='/topic/show?id=1e2c92e53e' target=_blank style='color:#2F92EE;'>#IABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9275, encryptionId=1e2c92e53e, topicName=IABP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cba419597616, createdName=ms4964546379600229, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2018-03-15 snowpeakxu

    #专家共识#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1844800, encodeId=4fd3184480059, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Mar 15 04:31:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049821, encodeId=66ac2049821ed, content=<a href='/topic/show?id=4a5f1e68a9' target=_blank style='color:#2F92EE;'>#ABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1768, encryptionId=4a5f1e68a9, topicName=ABP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Tue Jan 16 08:31:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663906, encodeId=6d621663906dd, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Wed Aug 23 18:31:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492361, encodeId=aef0149236132, content=<a href='/topic/show?id=a251569194f' target=_blank style='color:#2F92EE;'>#搭桥术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56919, encryptionId=a251569194f, topicName=搭桥术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32a28924986, createdName=zzc2214, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552137, encodeId=5505155213e05, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615308, encodeId=86761615308c5, content=<a href='/topic/show?id=1e2c92e53e' target=_blank style='color:#2F92EE;'>#IABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9275, encryptionId=1e2c92e53e, topicName=IABP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cba419597616, createdName=ms4964546379600229, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2018-01-16 wleon8895

    #ABP#

    0

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    2017-08-23 12498b3em16(暂无昵称)

    #搭桥#

    0

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    2017-08-16 zzc2214

    #搭桥术#

    0

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    2017-08-16 mei536

    #CHC#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1844800, encodeId=4fd3184480059, content=<a href='/topic/show?id=5d2f206482e' target=_blank style='color:#2F92EE;'>#专家共识#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20648, encryptionId=5d2f206482e, topicName=专家共识)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Mar 15 04:31:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2049821, encodeId=66ac2049821ed, content=<a href='/topic/show?id=4a5f1e68a9' target=_blank style='color:#2F92EE;'>#ABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1768, encryptionId=4a5f1e68a9, topicName=ABP)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Tue Jan 16 08:31:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1663906, encodeId=6d621663906dd, content=<a href='/topic/show?id=03a35691e2e' target=_blank style='color:#2F92EE;'>#搭桥#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56917, encryptionId=03a35691e2e, topicName=搭桥)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=557f25711234, createdName=12498b3em16(暂无昵称), createdTime=Wed Aug 23 18:31:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492361, encodeId=aef0149236132, content=<a href='/topic/show?id=a251569194f' target=_blank style='color:#2F92EE;'>#搭桥术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56919, encryptionId=a251569194f, topicName=搭桥术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=32a28924986, createdName=zzc2214, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552137, encodeId=5505155213e05, content=<a href='/topic/show?id=2d194589f3' target=_blank style='color:#2F92EE;'>#CHC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4589, encryptionId=2d194589f3, topicName=CHC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0cbf14265668, createdName=mei536, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615308, encodeId=86761615308c5, content=<a href='/topic/show?id=1e2c92e53e' target=_blank style='color:#2F92EE;'>#IABP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9275, encryptionId=1e2c92e53e, topicName=IABP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cba419597616, createdName=ms4964546379600229, createdTime=Wed Aug 16 01:31:00 CST 2017, time=2017-08-16, status=1, ipAttribution=)]
    2017-08-16 ms4964546379600229

    #IABP#

    0