中国医药
中國醫藥
중국의약
CHINA MEDICINE
2009年
8期
572-574
,共3页
急性心肌梗死%现场抢救%转送%回顾性研究
急性心肌梗死%現場搶救%轉送%迴顧性研究
급성심기경사%현장창구%전송%회고성연구
Acute myocardial infarction%Rescue scene%Transportation%Retrospective study
目的 探讨现场对急性心肌梗死的诊断、抢救及转送医院的时机与措施.方法 回顾性分析2002年3月至2005年1月我院急救中心现场抢救急性心肌梗死患者66例的临床资料.结果 66例患者包括26例下壁心肌梗死及40例其他部位梗死患者.12例现场溶栓患者血管再通8例(66.6%),其中发生再灌注心律失常5例(占41.6%,包括室性期前收缩2例、加速性室性心动过速1例、房性期前收缩2例).截至出院遗留后遗症51例,包括广泛前壁坏死性Q波13例,下壁坏死性Q波18例,前间壁坏死性Q波10例,遗留心房颤动6例,心力衰竭4例.溶栓治疗30 d内无消化道出血、脑出血及皮肤大面积淤血现象出现.结论 急性心肌梗死的早期诊断和现场抢救,主要根据临床表现和心电图判断,将有指征的患者及时转运到有条件行PCI的医院,及早进入治疗程序、恢复心肌血液灌注是争取救治时间,提高抢救成功率的关键.
目的 探討現場對急性心肌梗死的診斷、搶救及轉送醫院的時機與措施.方法 迴顧性分析2002年3月至2005年1月我院急救中心現場搶救急性心肌梗死患者66例的臨床資料.結果 66例患者包括26例下壁心肌梗死及40例其他部位梗死患者.12例現場溶栓患者血管再通8例(66.6%),其中髮生再灌註心律失常5例(佔41.6%,包括室性期前收縮2例、加速性室性心動過速1例、房性期前收縮2例).截至齣院遺留後遺癥51例,包括廣汎前壁壞死性Q波13例,下壁壞死性Q波18例,前間壁壞死性Q波10例,遺留心房顫動6例,心力衰竭4例.溶栓治療30 d內無消化道齣血、腦齣血及皮膚大麵積淤血現象齣現.結論 急性心肌梗死的早期診斷和現場搶救,主要根據臨床錶現和心電圖判斷,將有指徵的患者及時轉運到有條件行PCI的醫院,及早進入治療程序、恢複心肌血液灌註是爭取救治時間,提高搶救成功率的關鍵.
목적 탐토현장대급성심기경사적진단、창구급전송의원적시궤여조시.방법 회고성분석2002년3월지2005년1월아원급구중심현장창구급성심기경사환자66례적림상자료.결과 66례환자포괄26례하벽심기경사급40례기타부위경사환자.12례현장용전환자혈관재통8례(66.6%),기중발생재관주심률실상5례(점41.6%,포괄실성기전수축2례、가속성실성심동과속1례、방성기전수축2례).절지출원유류후유증51례,포괄엄범전벽배사성Q파13례,하벽배사성Q파18례,전간벽배사성Q파10례,유류심방전동6례,심력쇠갈4례.용전치료30 d내무소화도출혈、뇌출혈급피부대면적어혈현상출현.결론 급성심기경사적조기진단화현장창구,주요근거림상표현화심전도판단,장유지정적환자급시전운도유조건행PCI적의원,급조진입치료정서、회복심기혈액관주시쟁취구치시간,제고창구성공솔적관건.
Objective To report our experience of rescuing acute myocanfial infarction on spot. Methods Clinical data of 66 patients with AMI salvage at scene by emergency rescue centre of our hospital from March 2002 to January 2005 was reviewed. Results There were 26 patients with inferior myocardial infarction and 40 patients with the other parts myocardial infarction. Eight of 12 patients (66.7%) received thmmholytic therapy at scene. Five patients got the reperfusion arrhythmias RA (41.6%, 2 patients with premature ventricualr contraction, 1 patients with accelerated ventricular tachycardia, 2 patients with premature atrial contraction). There were 51 cases with sequela, including 13 cases with widespread anterior wall necrotic Q wave, 18 cases with inferior wall necrotic Q wave, 10 cases with antero-septal wall necrotic Q wave, 6 cases with atrial fibrillation and 4 cases with cardia failure. During 30 days of thrombolytic therapy, there was no alimentary tract hemorrhage, cerebral hemorrhage and widespread skin congestion. Conclusion Early diagnosis of AMI should be primarily made according to clinical manifestation and ECG. Early access to treatment procedures and rehabilitation myocardial peffusion is the key to success-ful resuscitation.
