急诊介入治疗急性心肌梗死心肺复苏术后患者的疗效观察

THE CURATIVE EFFECT OF EMERGENCY INTERVENTIONAL OPERATION IN THE TREATMENT OF ACUTE MYOCARDIAL INFARCTION AFTER CARDIOPULMONARY RESUSCITATION

目的探讨急性心肌梗死(AMI)患者心肺复苏(CPR)后行急诊经皮冠状动脉介入术(PCI)的疗效。方法回顾性分析AMI接受CPR后存活的患者96例,根据复苏后是否接受急诊PCI将之分为介入组(65例)和保守组(31例),研究急性心肌梗死心肺复苏术后患者冠状动脉的病变特征,并比较二组不良事件发生率。比较二组住院期间的病死率、心力衰竭、心源性休克、严重出血、骨折、支架内血栓的形成比率。结果保守组在院期间死亡率和心源性休克的发生率均明显高于介入组,比较差异有统计学意义(P<0.05)。结论心梗后猝死病例多为前降支近中段完全闭塞,冠脉三支病变者居多,急诊冠脉介入是治疗心肌梗死后心肺复苏患者的有效救治措施。

Objective To discuss the curative effect of acute myocardial infarction （AMI） after cardiopulmonary resuscitation （CPR） percutaneous coronary interention （PCI）. Methods A retrospective analysis of CPR after AMI, and survive after 96 cdses of patients, according to whether to accept after recovery of emergency PCI were divided into intervention group （ n = 65 ） and the conservative group （ n = 31 ）, the cardiopulmonary resuscitation （CPR） after acute myocardial infarction patients with coronary artery lesion characteristics, and compare the two groups the incidence of adverse events. Comparison of two groups of inhospital mortality, heart failure, cardiogenic shock, severe bleeding, fractures, the incidence of stent thrombosis. Results The conservative group inhospital mortality and the incidence of the original shock were significantly higher than that of intervention group, the difference was statistically significant （P〈0. 05）. Conclusions After myocardial infarction, sudden death in patients with anterior descending mostly near the middle occlusion, coronary tended to three lesions in emergency coronary intervention in the treatment of myocardial infarction patients after cardiopulmonary resuscitation （CPR） is a positive and effective rescue measures.