PCI中再灌注心律失常108例观察及护理

Observation and Nursing care of Reperfusion Arrhythmias with Emergency PCI in 108 Patients

目的:探讨急性心肌梗死(AMI)患者行急诊冠脉介入治疗时再灌注心律失常的发生特点及其护理方法。方法:回顾性分析我院273例AMI患者行急诊PCI治疗的病史资料。结果:在273例接受急诊PCI治疗的患者中,共有108例发生再灌注心律失常。再灌注心律失常类型与冠脉血管病变特点相关。前壁梗死发生快速型心律失常较多,下壁梗死发生缓慢型心律失常多见。64例发生严重缓慢性心律失常患者经阿托品及临时起搏器治疗后复律。8例快速型室性心动过速患者给予胺碘酮后恢复窦性心律。11例发生心室颤动经电除颤后恢复窦性心律。结论:再灌注心律失常在急诊PCI术中发生率较高;其类型与心肌梗死部位有关,急诊PCI术的护理观察、抢救配合和术前的充分准备对急诊PCI术中再灌注心律失常的成功治疗具有重要意义。

Objective： To study the characteristics and nursing methods of reperfusion arrhythmias in patients with AMI treated by emergency Pereutaneous coronary intervention（PCI）.Methods：Clinical data of 273 emergency PCI cases were retrospectively analyzed＋Results： Reperfusion arrhythmias occurred in 108 patients. Types of reperfusion arrhythmias associated with the characteristics of coronary artery leision. Reperfusion bradycardia was more common in inferior infarction and can be treated with atropine and/or temporary pacing. However, reperfusion taehycardia is more often seen in patients who developed anterior infarction.Conclusions：Incidence of reperfusion arrhythmias was high in the emergency PCI procedure. The underlying coronary lesion and infarction sites was related to the types of reperfusion arrhythmias. Extensive monitoring and nursing assistance is very important to the successful treatment of reperfusion arrhythmias.