急性心肌梗死心搏骤停心肺复苏后静脉溶栓并转上级医院行PCI治疗的效果

Effect of Intravenous Thrombolysis and Transfer to Superior Hospitals for PCI in Treatment of Acute Myocardial Infarction and Cardiac Arrest After Cardiopulmonary Resuscitation

目的:探讨急性心肌梗死心搏骤停心肺复苏后静脉溶栓并行经皮冠状动脉接入术(PCI)治疗的效果。方法:选取2012年1月—2022年12月洞口县人民医院急诊科收治的急性心肌梗死心搏骤停心肺复苏成功的患者62例作为研究对象,采用随机数字表法分为对照组与试验组,各31例。对照组心肺复苏成功后接受常规治疗,立即转上级医院行PCI治疗。试验组心肺复苏成功后除常规治疗外,予以静脉溶栓治疗2 h后再转至上级医院行PCI治疗。比较两组治疗效果。结果:试验组转院途中心源性休克、恶性心律失常、心搏骤停发生率均低于对照组,差异有统计学意义(P<0.05)。试验组血管再通率及左室射血分数高于对照组,左室舒张末期内径小于对照组,差异有统计学意义(P<0.05)。试验组PCI术后住院时间短于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:急性心肌梗死心搏骤停患者心肺复苏后静脉溶栓并转上级医院行PCI治疗的效果显著,可降低转院途中的意外事件发生风险,提高血管再通率,改善患者心功能,缩短PCI术后住院时间,降低并发症发生率。

Objective:To investigate the effect of percutaneous coronary intervention(PCI) with intravenous thrombolysis after cardiopulmonary resuscitation in treatment of acute myocardial infarction and cardiac arrest.Methods:A total of 62 patients with acute myocardial infarction and cardiac arrest after successful cardiopulmonary resuscitation admitted to the Emergency Department of Dongkou County People's Hospital from January 2012 to December 2022 were selected as the study subjects.These patients were divided into control group and experimental group by random number table method,with 31 cases in each group.After successful cardiopulmonary resuscitation,the control group received conventional treatment and immediately transferred to a superior hospital for PCI treatment.After successful cardiopulmonary resuscitation,the experimental group received intravenous thrombolysis therapy for 2 h and then transferred to a superior hospital for PCI treatment in addition to conventional treatment.The treatment effects of the two groups were compared.Results:The incidence of cardiac shock,malignant arrhythmia and cardiac arrest in the experimental group was lower than that in the control group during transfer,and the differences were statistically significant(P<0.05).The vascular recanalization rate and left ventricular ejection fraction in the experimental group were higher than those in the control group,and the left ventricular end-diastolic diameter in the experimental group was smaller than that in the control group,and the difference was statistically significant(P<0.05).The hospital stay after PCI in the experimental group was shorter than that in the control group,and the complication rate in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:For patients with acute myocardial infarction and cardiac arrest undergoing intravenous thrombolysis after cardiopulmonary resuscitation,transfer to superior hospitals for PCI has a significant effect,which can reduce the risk of accidental events during transfer,increase vascular recanalization rate,improve cardiac function,shorten the hospital stay after PCI surgery,and reduce the incidence of complications.