摘要
目的:探讨联用经皮冠状动脉介入治疗(PCI)和心脏临时起搏器植入术治疗急性心肌梗死并发缓慢性心律失常的临床效果。方法:将2015年1月至2017年12月期间西安市北方医院收治的42例急性心肌梗死并发缓慢性心律失常患者作为研究对象,并将其分为对照组和试验组。对两组患者均进行常规治疗。在此基础上,对对照组患者进行PCI,为试验组患者联用PCI和心脏临时起搏器植入术进行治疗。然后,比较两组患者治疗前后LVEDD (左心室舒张末期内径)的水平、LVEDS(左心室收缩末期内径)的水平、LVEF(左心室射血分数)、CO(心输出量)的水平、BNP(钠尿肽)的水平、Mb(肌红蛋白)的水平、cTnⅠ(心肌肌钙蛋白Ⅰ)的水平、不良反应的发生率及其治疗前后CCQQ的评分。结果:治疗后,与对照组患者相比,试验组患者LVEDD、LVEDS、BNP、Mb、cTnⅠ的水平及不良反应的发生率均更低,其CO的水平、LVEF及CCQQ的评分均更高(P <0.05)。结论:联用PCI和心脏临时起搏器植入术治疗急性心肌梗死并发缓慢性心律失常的临床效果确切,可有效地改善患者的心肌功能,提高患者的生活质量。
objective:to investigate the clinical effect of combined percutaneous coronary intervention(PCI)and temporary cardiac pacemaker implantation in the treatment of acute myocardial infarction complicated with chronic arrhythmia.Methods:42 patients with acute myocardial infarction complicated with chronic arrhythmia admitted to xi‘an north hospital from January 2015 to December 2017 were selected as the study subjects and divided into control group and experimental group.Both groups were treated with conventional therapy.On this basis,patients in the control group were treated with PCI,and patients in the experimental group were treated with PCI combined with implantation of cardiac temporary pacemaker.Then,to compare two groups of patients before and after treatment LVEDD(left ventricular enddiastolic diameter)levels,LVEDS(left ventricular end systolic diameter)levels,LVEF,left ventricular ejection fraction),the levels of CO(cardiac output),the levels of BNP(natriuretic peptides)and Mb(myoglobin)levels,cTnⅠ(myocardial troponinⅠ)level,the incidence of adverse reactions and CCQQ ratings before and after treatment.Results:after treatment,compared with the control group patients,the treatment group patients LVEDD,LVEDS,BNP,Mb,cTnⅠlevels and the incidence of adverse reactions are lower,the ratings of the levels of CO,LVEF and CCQQ were higher(P<0.05).Conclusion:PCI combined with temporary cardiac pacemaker implantation is effective in the treatment of acute myocardial infarction complicated with chronic arrhythmia,which can effectively improve the myocardial function and improve the quality of life of patients.
作者
毛明洁
薛小林
Mao Mingjie;Xue Xiaolin(Xi’an jiaotong university,Xi’an Shanxi 710043;Xi’an north hospital,Xi’an Shanxi 710043)
