Аннотация
В результате анализа литературных данных установлено, что для понимания особенностей ведения
больных ишемической болезнью сердца в раннем периоде после коронарного шунтирования,
достигших 70 лет и более, а также снижения риска осложнений и неблагоприятных исходов
необходимы дальнейшие исследования. Оправданно использование как медикаментозной
профилактики, особенно для предупреждения нарушений ритма, так и немедикаментозных методов
снижения риска развития послеоперационных осложнений. Наиболее важна ранняя активизация
пациентов в послеоперационном периоде, что обеспечивает снижение риска тромбозов и эмболий,
ускорение физического и психологического восстановления. Целесообразно применение
органопротекции, сокращение продолжительности искусственной вентиляции легких, четкое
соблюдение жидкостного баланса и гемотрансфузии. Выявлено преимущество эпидуральной
анестезии по сравнению с ингаляционным наркозом в виде значимого уменьшения
послеоперационной дыхательной недостаточности, улучшения показателей газового состава крови,
а также более быстрого восстановления самостоятельного дыхания. Отмечено снижение
госпитальной летальности и частоты инсультов у пациентов старше 70 лет при отказе от
использования искусственного кровообращения или уменьшении его длительности.
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Об авторах
Лобачева Галина Васильевна, доктор мед. наук, профессор, заведующая отделением реанимации
и интенсивной терапии