急性下壁合并右室心肌梗死临床特点及分析

Clinical Features and Analysis of AcuteInferior wall Myocardial Infarction with Right Ventricular Myocardial Infarction

目的探讨急性下壁心肌梗死(合并或不合并右室心肌梗死)患者的危险因素、临床特征、治疗措施,以提高对急性下壁心肌梗死的治疗水平。方法选择2008～2012年我院急诊科收治的急性下壁心肌梗死患者59例。将所有符合急性下壁心肌梗死且资料完整的病例分为单纯下壁心肌梗死组和下壁合并右室心肌梗死组,比较两组患者的危险因素、临床特征、治疗效果的差异。结果两组间合并有高血压、糖尿病、吸烟、高脂血症等指标比较差异均无显著性(P>0.05)。单纯下壁心肌梗死与下壁心肌梗死合并右室心肌梗死患者收缩压、舒张压、第一个24h补液量等指标比较差异均有显著性(P≤0.05),两组患者死亡率有显著差异(4.44%vs 28.57%)。结论单纯下壁心梗与下壁合并右室心梗组出现低血压休克分别为6.67%与28.57%,快速大量液体输入扩容是抢救下壁合并右心室心肌梗死患者成功的关键,急性下壁合并右室心肌梗死患者中早期再灌注治疗,快速有效的开通罪犯血管可明显改善患者右心功能。

Objective By evaluating the risk factor , clinical feature and therapeutic results of patients who suffer acute inferior wall myocardial infarction with right ventricular myocardial infarction with retrospective study. Methods The patients who were diagnosed of acute inferior wall myocardial infarction in The People＇ s Hospital of Wei Fang （2008 to 2012） were enrolled and chosen. All cases were divided into two groups： in- ferior wall myocardial infarction group and inferior wall myocardial infarction with right ventricular myocardial infarction group. Risk factors, clinical features and therapeutic efficacy were compared between the two groups. Results There was no difference between two groups in the following risk factors such as hyperten- sion, diabetes, smoking, hypedipidemia（P 〉 0.05 ）. Systolic blood pressure （ SBP）, diastolic blood pressure （DBP） and the amount infused for the first 24h were significantly different（P≤0.05）. Conclusion The in- cidence of hypotensive shock in the two groups was markedly （6.67 % and 28.57% ）. Expansion treatment is the key of successful rescue. Early reperfusion treatment Could improve right ventricular function.