急性心肌梗死合并阿斯综合征患者病情观察及护理抢救分析

Nursing of patients with acute myocardial infarction complicated with Adams-Stoke syndrome and condition observation

目的探讨急性心肌梗死(AMI)合并阿斯综合征急救和护理方法。方法回顾性分析14例AMI合并阿斯综合征患者,采用四早原则进行抢救,即早心电监护、早识别、早行电除颤和胸外心脏按压,早建立静脉通道和抗心律失常以营养心肌药物,观察治疗后效果情况。结果治疗后存活11例,死亡3例,存活率78.57%,治疗12 h后在AST、CK、CKMB、α-HBDH上较治疗前均显著下降,而LDH则较治疗前显著提高,治疗前后比较差异显著(P<0.05);治疗12 h后在HR、QTd上较治疗前显著下降,QTc较治疗前显著提高,治疗前后差异显著(P<0.05);治疗前心功能分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级比率分别为0、7.14%、21.43%、71.43%,治疗12 h后心功能分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级比率分别为57.14%、21.43%、0、0,治疗前后差异显著(P<0.05)。结论 AMI合并阿斯综合征早期急救并加强护理是降低死亡率,提高存活率关键。

Objective To investigate rescue and nursing of patients with acute myocardial infarction（ AMI） complicated with Adams-Stoke syndrome. Methods A total of 14 AMI patients combined with Adams-Stoke syndrome was applied four principles early rescue which was early ECG monitoring,early identification,early defibrillation row and chest compressions and early establishment of intravenous access and nutrition cardiac antiarrhythmic drugs,the therapeutic effect was observed. Results After treatment,there were 11 cases survived,and 3 cases died,and the survival rate was 78. 57%. After 12 h treatment,AST,CK,CKMB and α-HBDH decreased significantly compared with treatment before,while LDH was significantly compared with pre-treatment,there was significant difference before and after treatment（ P 〈 0. 05）; After 12 h treatment,HR and QTd before treatment was decreased significantly,and QTc was significantly increased than treatment before,there were significant difference after treatment（ P 〈 0. 05）; The ratio of cardiac function grade forⅠ,Ⅱ,Ⅲ and Ⅳ before treatment were 0,7. 14%,21. 43%,71. 43%,and were 57. 14%,21. 43%,0,and 0 after 12 h of treatment（ P 〈 0. 05）. Conclusion Early rescue and nursing for AMI patients can reduce mortality,and improve survival rate of patients.