降低急性心肌梗塞病死率的探讨(附44例临床资料)

EXPERIENCE IN REDUCTION OF MORTALITY FROM ACUTE MYOCARDIAC INFARCTION

本文分析了我科1989年住院的急性心肌梗塞44例,其中60岁以上19例,合并心律失常39例,心力衰竭8例,心源性休克4例,其它合并症8例,死亡1人,病死率为2.27％。较目前急性心肌梗塞病死率10～15％有所下降。作者认为:密切监护、积极防治心律失常、持续静滴硝酸甘油、积极溶栓、保持大便通畅避免用力排便、合理安排卧床时间、综合措施治疗心力衰竭及心源性休克,预防恢复期室颤,及时发现正确处理右室梗塞是降低急性心肌梗塞病死率的重要措施。

During 1989, 44 patients with acute myocardiac infarction were admitted to our department, including 19 patients over 60 years old (43％). By retrospective analysis, it was found that 39 of the 44 patients complicated by arrhythmia, 4 by cardogenic shock, and 8 by heart failure. One patient died, the mortality being 2.27％, i.e. the present internal mortality of 10—15% declined to 2.27％. Basing on the above findings, the authors suggest that the important measures of reducing the mortality from acute myocardiac infarction are monitoring the condition of patients carefully, to prevent and treat arrhythmias actively, intravenous dripping nitroglycerine continuously, directly lysing a already formed thrombus with thrombolytic therapy, to prevent constipation and to keep the bowels free movement, to arrange bed rest properly, treatment of heart failure and cardiogenic shock with comprehensi ve measures, prevention of ventricular fibrillation during convalescence, and to discover right ventricular infarction timely and treat them correctly.