院前院内持续镇静镇痛治疗对急性冠脉综合征患者预后的影响

Effects of continuous sedation and analgesia before and after admission on prognosis of patients with acute coronary syndrome

目的:探讨院前院内持续镇静镇痛对急性冠脉综合征患者预后的影响。方法:选取急性冠脉综合征患者186例,采用随机数字表法分为两组,对照组患者93例实施院前镇痛治疗,观察组患者93例实施院前院内持续镇静镇痛治疗,两组治疗前后行生命体征指标监测,并行心肌酶指标检测,比较两组患者的预后状况。结果:治疗后,两组患者心率、呼吸频率、舒张压、平均动脉压、中心静脉压、谷草转氨酶、乳酸脱氢酶、肌酸激酶同工酶、心肌肌钙蛋白Ⅰ、C反应蛋白均较治疗前降低(P<0.05),且观察组降低幅度大于对照组,两组患者左室射血分数增加(P<0.05),且观察组增加幅度大于对照组,观察组患者预后状况好于对照组(P<0.05)。结论:院前院内持续镇静镇痛可改善急性冠脉综合征患者预后的效果,优于单纯院前镇痛治疗效果。

Objective：To investigate effect of continuous sedation and analgesia before and after admission on prognosis of patients with acute coronary syndrome.Methods：186 patients with acute coronary syndrome were selected and divided into two groups by the random digital table method.93 patients received preemptive analgesia（as control group）,while another 93 patients received continuous sedation and analgesia before and after admission（as observation group）.The vital signs monitoring was finished before and after treatment,while the myocardial enzyme indexes were detected.Then,the prognosis of the patients was compared between the two groups.Results：The heart rate,respiratory rate,diastolic blood pressure,mean arterial pressure,central venous pressure,aspartate aminotransferase,lactate dehydrogenase,creatine kinase isoenzyme,cardiac troponin I,C reactive protein decreased in the two groups after the treatment（P〈0.05）,and the reduction in the observation group was greater than that of the control group.The left ventricular ejection fraction increased in the two groups after the treatment（P〈0.05）,and the increase in the in the observation group was greater than that of the control group.Moreover,the prognosis in the observation group was better than that in the control group（P 〈0.05）.Conclusions：Continuous sedation and analgesia before and after admission is more effective than preemptive analgesia in the improvement of the prognosis of the patients with acute coronary syndrome.