經皮冠狀動脈成形術後病患之護理

The Nursing Care for Patients Underwent Percutaneous Transluminal Coronary Angioplasty

隨著技術精進，經皮冠狀動脈成形術(PTCA)之適應症更廣，臨床上接受此類治療之病患數快速增加且病況趨複雜化，因而，相關知識之提昇及臨床照護措施之精進益形重要。故本文藉由文獻查證，探討PTCA之治療步驟；降低PTCA術後合併症相關之止血法、臥姿及臥床時間、監測ACT及拔除指引導管之時機等層面；PTCA術後促進病患舒適、維持週邊組織灌流、預防合併症發生及維持足夠心輸出量之護理措施，及出院的傷口護理、居家藥物服用、運動、危險因子控制、再阻塞症狀及追蹤治療重要性之護理指導等內容，以提供PTCA術後臨床照護指引，助益於臨床實務及病患。

Due to the improvement of medical technique, the value of Percutaneous Transluminal Coronary Angioplasty (PTCA) has been widely appreciated. The number of patients receiving this treatment has increased greatly and the nature of the disease treated by PTCA has also become more complicated. It is important to advance the knowledge and nursing care intervention of PTCA. The purposes of this article were to introduce the process of PTCA, the aspects in technique of hemostats, position and time in bed, timing of activated clotting time levels and removal of the sheath. Nursing interventions in promoting patient comfort, maintenance of peripheral tissue perfusion, prevention of complications and maintenance of adequate cardiac output after PTCA; discharge education, including wound care, medication, exercise, risk factors, signs of occlusion and the importance of follow up were also discussed. This article provided a guideline for post-PTCA care, which was useful for both healthcare providers and patients.