接受冠狀動脈繞道手術病人之病生理變化

Pathophysiological Changes in Patients Who Have Undergone Coronary Artery Bypass Graft Surgery

冠狀動脈繞道手術為冠狀動脈疾病的重要治療方式之一，現今手術知識與技術的純熟，使得冠狀動脈繞道手術成為普遍應用於嚴重阻塞二條、三條冠狀動脈血管疾病的標準治療。但手術過程與體外循環機的使用，造成心肌的損傷及其所引發的免疫反應，會對身體各系統造成傷害，進而可能會影響到病人復原的時間及預後的程度等。本文目的是以學理做基礎，討論冠狀動脈繞道手術後病人的病生理變化，並提出變化後所造成的影響，最後以照顧一位病人的疾病過程為例，針對此病人提出個別且適宜的護理措施，期經此案例可以提供臨床護理人員在照顧此類病人的參考，且經由學理的配合更能提昇病人的照護品質。

Coronary artery bypass graft (CABG) surgery is indicated for patients with coronary artery disease in order to relieve symptoms, improve life quality and prolong life. Gradual improvements in operative techniques and perioperative care have made CABG surgery an increasingly common treatment option for those with coronary artery disease. Injury to the myocardium, inflammatory responses due to intraoperative events and potential complications with extracorporeal circulation are primary issues that may negatively impact patient outcomes. This article describes concepts related to the pathophysiology of one patient who underwent a coronary artery bypass graft surgery and offers a single case study to compare clinical findings against established theoretical and empirical knowledge. The individualized nursing intervention for this case is presented and discussed as well.