心脏冠状动脉搭桥手术的准备.docVIP

心脏冠状动脉搭桥手术的准备 Under local anesthesia, percutaneous right (or left) of femoral artery puncture, after coronary angiography, using a special balloon dilatation of the lesion, the balloon catheter with support to the lesion site, with 8 atmospheric pressure balloon 30 ~ 60 seconds of stent implantation. Then, use a high pressure balloon to pressurize 12~16 atmospheres for 30~60 seconds to ensure a uniform expansion of the stent. The stent will permanently implant into the patients coronary intima. After operation, the femoral artery sheath tube was inserted, and heparin sodium 12500 U was injected. After operation, the heparin sodium 2500 U was injected every extended 1H, and the total volume was 20 000 U. To prevent coronary spasm during operation, nitroglycerin 200~300 g was injected into the coronary artery before stent delivery and balloon withdrawal. Postoperative care: Postoperative CCU24h, intensive ECG monitoring, monitoring of prothrombin time (PT), careful observation of recurrent angina, femoral artery wound bleeding, dorsalis pedis artery pulse. Prevention and monitoring of stent thrombosis 1, strict anticoagulant treatment. The most important complications of stent implantation are acute and subacute thrombosis. Attention should be paid to anticoagulant therapy. All patients who have not undergone high pressure balloon dilatation or high pressure balloon dilatation, stents have not reached the ideal results, hypercoagulable state, and implanted multiple stents, we need to closely monitor the PT and strengthen anticoagulation treatment. Effective anticoagulant indexes are: 24h, PT after operation, to be achieved and maintained at 24s. Nursing to patients with aspirin plus ticlopidine + heparin anticoagulation drugs, including heparin, the key is reasonable. We summed up two uses based on the PT test results: The unfractionated heparin: postoperative 6h without bleeding wounds that intravenous injection of heparin calcium 7500 U, then 12500 U heparin sodium