中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2011年
26期
3128-3131
,共4页
心肌梗死%经皮冠状动脉介入治疗%替罗非班%护理
心肌梗死%經皮冠狀動脈介入治療%替囉非班%護理
심기경사%경피관상동맥개입치료%체라비반%호리
Myocardial infarction%PCI%Tirofiban%Nursing
目的 探讨替罗非班在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)中应用的效果和护理要点.方法 选择124例AMI行急诊PCI患者,随机分成替罗非班组(68例)和常规组(56例).两组PCI围手术期均予常规抗血栓治疗,替罗非班组在此基础上术前另予替罗非班应用.比较两组PCI术中梗死相关动脉TIMI血流情况、术后ST段回落程度、出血并发症、主要心血管不良事件(MACE)发生率等情况.对替罗非班组做好药物维持期间的护理及健康指导等.结果 替罗非班组术后TIMI血流分级明显高于常规组,差异具有统计学意义(x2=6.4,P＜0.05);ST段回落不良率低于常规组,差异具有统计学意义(4.4％比16.1％,x2=4.78,P＜0.05);心血管事件总发生率明显降低,差异具有统计学意义(2.9％比16.1％,x2=5.03,P＜0.05);左室射血分数高于常规组,差异具有统计学意义[(57.6±2.3)％比(55.3±1.9)％,t =5.99,P＜0.01];轻微出血率高于常规组,但差异无统计学意义(P＞0.05).结论 AMI急诊PCI患者在常规抗血栓治疗的基础上联合应用替罗非班能有效改善心肌组织水平灌注和左心功能,减少PCI术后MACE的发生,疗效确切,但可增加出血的危险性,在治疗中实施有效的护理和密切观察,及时发现并处理并发症,可确保治疗的顺利进行,提高患者的治疗效益并保证用药安全.
目的 探討替囉非班在急性心肌梗死(AMI)急診經皮冠狀動脈介入治療(PCI)中應用的效果和護理要點.方法 選擇124例AMI行急診PCI患者,隨機分成替囉非班組(68例)和常規組(56例).兩組PCI圍手術期均予常規抗血栓治療,替囉非班組在此基礎上術前另予替囉非班應用.比較兩組PCI術中梗死相關動脈TIMI血流情況、術後ST段迴落程度、齣血併髮癥、主要心血管不良事件(MACE)髮生率等情況.對替囉非班組做好藥物維持期間的護理及健康指導等.結果 替囉非班組術後TIMI血流分級明顯高于常規組,差異具有統計學意義(x2=6.4,P＜0.05);ST段迴落不良率低于常規組,差異具有統計學意義(4.4％比16.1％,x2=4.78,P＜0.05);心血管事件總髮生率明顯降低,差異具有統計學意義(2.9％比16.1％,x2=5.03,P＜0.05);左室射血分數高于常規組,差異具有統計學意義[(57.6±2.3)％比(55.3±1.9)％,t =5.99,P＜0.01];輕微齣血率高于常規組,但差異無統計學意義(P＞0.05).結論 AMI急診PCI患者在常規抗血栓治療的基礎上聯閤應用替囉非班能有效改善心肌組織水平灌註和左心功能,減少PCI術後MACE的髮生,療效確切,但可增加齣血的危險性,在治療中實施有效的護理和密切觀察,及時髮現併處理併髮癥,可確保治療的順利進行,提高患者的治療效益併保證用藥安全.
목적 탐토체라비반재급성심기경사(AMI)급진경피관상동맥개입치료(PCI)중응용적효과화호리요점.방법 선택124례AMI행급진PCI환자,수궤분성체라비반조(68례)화상규조(56례).량조PCI위수술기균여상규항혈전치료,체라비반조재차기출상술전령여체라비반응용.비교량조PCI술중경사상관동맥TIMI혈류정황、술후ST단회락정도、출혈병발증、주요심혈관불량사건(MACE)발생솔등정황.대체라비반조주호약물유지기간적호리급건강지도등.결과 체라비반조술후TIMI혈류분급명현고우상규조,차이구유통계학의의(x2=6.4,P＜0.05);ST단회락불량솔저우상규조,차이구유통계학의의(4.4％비16.1％,x2=4.78,P＜0.05);심혈관사건총발생솔명현강저,차이구유통계학의의(2.9％비16.1％,x2=5.03,P＜0.05);좌실사혈분수고우상규조,차이구유통계학의의[(57.6±2.3)％비(55.3±1.9)％,t =5.99,P＜0.01];경미출혈솔고우상규조,단차이무통계학의의(P＞0.05).결론 AMI급진PCI환자재상규항혈전치료적기출상연합응용체라비반능유효개선심기조직수평관주화좌심공능,감소PCI술후MACE적발생,료효학절,단가증가출혈적위험성,재치료중실시유효적호리화밀절관찰,급시발현병처리병발증,가학보치료적순리진행,제고환자적치료효익병보증용약안전.
Objective To study the efficacy and major nursing characteristics of Tirofiban in emergent PCI treatment of acute myocardial infarction (AMI).Methods The selected 124 patients with undergoing AMI emergency PCI were randomly divided into Tirofiban and control group,and all subjects were treated perioperative anti-thrombotic therapy,Tirofiban groups were treated with additional preoperative application of Tirofiban.Compare the 2 groups with the infarct-related artery PCI,TIMI flow,postoperative degree of ST segment resolution,bleeding complications,major adverse cardiac events (MACE) rate and so on.Take nursing to Tirofiban group during the medicine-taking period and give some instruction to them.Results The postoperative TIMI flow grade of Tirofiban group was significantly higher than the control group (x2 =6.4,P ＜0.05); ST segment resolution defect rate was lower than control group (4.4％ vs 16.1％,x2 =4.78,P ＜0.05); Cardiovascular events was significantly lower (2.9％ vs 16.1％,x2 =5.03,P ＜0.05).Left ventricular ejection fraction was higher than in the conventional group [ ( 57.6 ± 2.3 ) ％ vs (55.3 ± 1.9) ％,t =5.99,P ＜ 0.01 ] ; minor bleeding was higher than the conventional group,the difference was not statistically significant ( P ＞ 0.05 ).Conclusions AMI patients in the routine emergency PCI on the basis of anti-thrombotic therapy in combination with Tirofiban levels can improve myocardial perfusion and left ventricular function,reduce the incidence of MACE after PCI and curative effect,however,it can increase the risk of bleeding resistance,with a effective treatment and close observation,detect and deal with complications in time,to ensure the smooth progress of treatment,improve patient benefits and medication safety.
