体外心肺复苏术联合急诊PCI在急性心肌梗死后心脏骤停患者急救中的应用研究

Application of extracorporeal cardiopulmonary resuscitation combined with emergency PCI in emergency treatment of cardiac arrest after acute myocardial infarction

目的探讨体外心肺复苏术联合急诊经皮冠状动脉介入治疗(PCI)在急性心机梗死(AMI)后心脏骤停患者急救中的应用效果。方法回顾性分析郑州市第九人民医院2020年1月至2022年1月收治的82例AMI后心脏骤停患者的临床资料。将接受体外心肺复苏术治疗的41例设为对照组,将接受体外心肺复苏术联合急诊PCI治疗的41例设为观察组。比较两组抢救成功率、心功能、血流动力学指标及不良事件情况。结果观察组抢救成功率(95.12%,39/41)较对照组(80.49%,33/41)高,差异有统计学意义(χ^(2)=4.100,P<0.05)。治疗后,观察组左室射血分数较对照组高,心胸比值较对照组低,差异有统计学意义(P<0.05)。观察组治疗后24 h、72 h时心率较对照组低,平均动脉压较对照组高,差异有统计学意义(P<0.05)。观察组不良事件发生率为12.82%(5/39),较对照组[36.36%(12/33)]低,差异有统计学意义(χ^(2)=5.493,P=0.019)。结论体外心肺复苏术联合急诊PCI能提高AMI后心脏骤停患者抢救成功率,加快血流动力学指标复常,减轻心功能损害,减少不良事件发生。

Objective To investigate the effect of extracorporeal cardiopulmonary resuscitation combined with emergency percutaneous coronary intervention(PCI)in emergency treatment of cardiac arrest after acute myocardial infarction(AMI).Methods The clinical data of 82 patients with cardiac arrest after AMI admitted to the Ninth People’s Hospital of Zhengzhou from January 2020 to January 2022were retrospectively analyzed.The 41 patients who received extracorporeal cardiopulmonary resuscitation were set as the control group,and the 41 patients who received extracorporeal cardiopulmonary resuscitation combined with emergency PCI were set as the observation group.The rescue success rate,cardiac function,hemodynamic indexes and adverse events were compared between the two groups.Results The rescue success rate of the observation group(95.12%,39/41)was higher than that of the control group(80.49%,33/41),and the difference was significant(χ^(2)=4.100,P<0.05).After treatment,the LVEF of the observation group was higher than that of the control group,and the cardiothoracic ratio was lower than that of the control group(P<0.05).The HR of the observation group was lower than that of the control group at 24 h and 72 h after treatment,and the MAP was higher than that of the control group(P<0.05).The incidence of adverse events in the observation group was12.82%(5/39),which was less than that in the control group[36.36%(12/33)],with significant difference(χ^(2)=5.493,P=0.019).Conclusions Extracorporeal cardiopulmonary resuscitation combined with emergency PCI can improve the rescue success rate of patients with cardiac arrest after AMI,accelerate the normalization of hemodynamic indexes,reduce the damage of cardiac function and reduce the occurrence of adverse events.