CAJ | 학술논문

目的：探讨不同方式给予利伐沙班及生脉注射液用于急性冠脉综合征并发心源性休克的临床疗效。方法选择医院收治的患者90例，随机分为对照组和观察组，各45例。两组患者均给予抗休克和相应对症处理，对照组患者在经皮冠状动脉介入治疗（PCI）术后口服利伐沙班及使用微量泵持续静脉给予生脉注射液；观察组患者在PCI术前3 d口服利伐沙班并使用微量泵持续静脉给予生脉注射液，术后治疗同对照组，两组术后持续治疗10 d。结果治疗后，两组患者的血压均明显高于治疗前（ P﹤0.05），心率均低于治疗前（ P﹤0.05），且观察组在治疗24 h及治疗后血压及心率的改善幅度均显著优于对照组（ P﹤0.05）；两组患者心功能、凝血功能及血小板水平均得到显著改善（ P﹤0.05），且观察组改善幅度更明显（ P﹤0.05）；两组患者不良反应均较较轻，组间比较，差异无统计学意义（ P﹥0.05）。结论急性冠脉综合征并心源性休克患者PCI围手术期及术后给予利伐沙班和生脉注射液，能显著提高临床疗效，有效改善血压、心率及心功能、凝血功能和血小板水平，且无明显不良反应发生，值得临床推广。
목적：탐토불동방식급여리벌사반급생맥주사액용우급성관맥종합정병발심원성휴극적림상료효。방법선택의원수치적환자90례，수궤분위대조조화관찰조，각45례。량조환자균급여항휴극화상응대증처리，대조조환자재경피관상동맥개입치료（PCI）술후구복리벌사반급사용미량빙지속정맥급여생맥주사액；관찰조환자재PCI술전3 d구복리벌사반병사용미량빙지속정맥급여생맥주사액，술후치료동대조조，량조술후지속치료10 d。결과치료후，량조환자적혈압균명현고우치료전（ P﹤0.05），심솔균저우치료전（ P﹤0.05），차관찰조재치료24 h급치료후혈압급심솔적개선폭도균현저우우대조조（ P﹤0.05）；량조환자심공능、응혈공능급혈소판수평균득도현저개선（ P﹤0.05），차관찰조개선폭도경명현（ P﹤0.05）；량조환자불량반응균교교경，조간비교，차이무통계학의의（ P﹥0.05）。결론급성관맥종합정병심원성휴극환자PCI위수술기급술후급여리벌사반화생맥주사액，능현저제고림상료효，유효개선혈압、심솔급심공능、응혈공능화혈소판수평，차무명현불량반응발생，치득림상추엄。
Objective To investigate the clinical efficacy of different ways of giving rivaroxaban and Shengmai Injection in treating acute coronary syndrome complicated cardiogenic shock. Methods Totally 90 patients admitted to the hospital were randomly divided into the control group and the observation group,45 cases in each group. The two groups were given anti-shock and related symptomatic treat-ment,the control group was given rivaroxaban and micro-pump continuous intravenous Shengmai Injection after PCI;the observation group was given rivaroxaban and micro-pump continuous intravenous Shengmai Injection at 3 d before PCI,and the therapy after treat-ment as same as the control group. The two groups were treated for 10 d after operation. Results After treatment,the blood pressure of the two groups was significantly higher than before treatment( P ﹤ 0. 05),the heart rate was significantly lower than before treatment ( P ﹤ 0. 05),in the treatment of 24 h and after treatment,the blood pressure and heart rate in the observation group were significantly improved compared with those in the control group( P ﹤ 0. 05);the cardiac function,blood coagulation and platelet in the two groups were significantly improved compared with before treatment( P ﹤ 0. 05),and the observation group improved more obviously( P ﹤ 0. 05). The occurrence rate of the adverse reactions had no significant difference between the two groups( P ﹥ 0. 05). Conclusion Rivaroxaban combined with Shengmai Injection in treating acute coronary syndrome complicated cardiogenic shock during perioperative and postopera-tion period can significantly improve the clinical effect,effectively improve blood pressure and heart rate,heart function,blood coagulation and platelet function without obvious adverse reactions,and is worth of clinical promotion.