急性心肌梗死临床介入治疗的护理

Nursing care of acute myocardial infarction clinical intervention treatment by percutaneous transluminal coronary angioplasty

目的:通过分析急诊经皮穿刺冠状动脉腔内成形术(PTCA)及冠状动脉内支架(Intracoronary stent)置入术对急性心肌梗死(AMI)的急诊介入治疗方法,探讨急诊冠状动脉腔内成形术及冠状动脉内支架置入术对急性心机梗死行介入治疗的护理经验。方法:选取ST段抬高的35例急性心肌梗死发病时间在12 h以内,行急诊冠状动脉造影的急诊冠状动脉腔内成形术及冠状动脉内支架置入术治疗的患者的护理进行回顾性分析。结果:入选的急性心肌梗死35例行急诊冠状动脉造影。冠状动脉腔内成形术及冠状动脉内支架置入术成功率100%。术前梗死相关血管狭窄(93.1±5.8)%,术后残余狭窄(10.3±7.6)%。35例急性心肌梗死患者术后2例发生穿刺部位血肿,3例拔管时出现迷走反射性低血压,其余患者无并发症发生。结论:急性心肌梗死行急诊冠状动脉腔内成形术及冠状动脉内支架置入术成功率高,残余狭窄小,可获得较高的梗死相关血管再通率和较低的心肌梗死复发率和死亡率,同时可减少梗死面积,保护心功能。在急性心肌梗死急诊介入治疗的过程中,严密的观察,精心的、全方位的护理可降低心肌梗死的发生,促进患者的康复。

Objective To explore nursing experience of the cavity emergency coronary artery angioplasty and coronary stenting to interventional therapy in acute myocardial infarction through the analysis of emergency percutaneous coronary angioplasty（PTCA） and coronary stenting（intracoronary stent） to the treatment of acute myocardial infarction（AMI） treatment of the emergency intervention.Method Selected 35 hospitalized cases of the ST-segment elevation of acute myocardial infarction onset within 12 hours in May from 2006 to 2008.The care of patients who Underwent the emergency coronary artery imaging of emergency coronary artery lumen angiography and coronary stent were retrospectively analyzed.Results The selected 35 patients with acute myocardial infarction had emergency coronary artery imaging.Coronary angioplasty and coronary stenting was in the success rate of 100%.Preoperative infarct-related artery stenosis was（93.1 ± 5.8）%,postoperative residual stenosis was（10.3 ± 7.6）%.35 cases of patients with acute myocardial infarction occurred in two cases of puncture site hematoma,3 cases of vagus nerve refled hypotension,and the remaining patients had no complications.Conclusion Acute myocardial infarction which do emergency coronary angioplasty and coronary stenting has a high success rate and a small residual stenosis,the higher infarct-related artery recanalization rate and a lower recurrence rate and mortality,at the same time can reduce the infarct area,and protect the cardiac function.