Rioseco M J, del Barrio M, Olcoz J, Sarrate M I, Asiain M C
Unidad de Cuidados Intensivos, Universidad de Navarra.
Enferm Intensiva. 1998 Oct-Dec;9(4):151-9.
The mean age of patients with heart disease who require surgical treatment is increasing. In conjunction with the development of surgical and postoperative care techniques, the mortality rate of these patients has decreased. In our intensive care unit (ICU), we proposed to determine if older patients undergoing cardiac surgery had more morbidity and required more care than other patients. An evaluation was made of the differences in evolution and nursing requirements of patients over 70 and under 70 who had undergone heart surgery with extracorporeal circulation by assessing the complications. A retrospective comparative study was made of the records of 50 patients > or = 70 years and 50 patients < 70 years who had undergone cardiac surgery and were admitted to intensive care for postoperative care. An analysis was made of pathology before surgery, operative incidents, evolution and postoperative complications of different body systems, postoperative care in intensive care by examining nursing records, the duration of the ICU stay and the hospital stay. The results indicated that there were no significant differences between the two groups in mortality, ICU stay, and severe complications. Patients over 70 had more frequent arrhythmias and difficulties in maintaining an optimal respiratory function. Such patients require more nursing care and a longer hospital stay. However, it is concluded that age per se is not a contraindication for heart surgery.
需要接受手术治疗的心脏病患者的平均年龄正在上升。随着手术及术后护理技术的发展，这些患者的死亡率有所下降。在我们的重症监护病房（ICU），我们提议确定接受心脏手术的老年患者是否比其他患者有更多的发病率且需要更多护理。通过评估并发症，对70岁及以上和70岁以下接受体外循环心脏手术的患者在病情发展及护理需求方面的差异进行了评估。对50例年龄≥70岁和50例年龄＜70岁接受心脏手术并入住重症监护病房进行术后护理的患者的记录进行了回顾性比较研究。通过检查护理记录、ICU住院时间和住院时间，对术前病理、手术事件、不同身体系统的病情发展及术后并发症、重症监护中的术后护理进行了分析。结果表明，两组在死亡率、ICU住院时间和严重并发症方面无显著差异。70岁以上的患者心律失常更频繁，维持最佳呼吸功能也有困难。这类患者需要更多的护理和更长的住院时间。然而，得出的结论是年龄本身并非心脏手术的禁忌证。
