Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI

BACKGROUND:This study investigated the effects of the intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).METHODS:Seventy-eight STEMI patients with age>65 years who underwent emergency PCI were consecutively enrolled.These patients received conventional PCI and were randomly divided into a control group and a treatment group(n=39 per group).The control group received an intracoronary injection of tirofiban followed by a maintenance infusion for 36 hours after surgery.The treatment group received intracoronary injection of tirofiban and nicorandil,and then intravenous infusion of tirofiban and nicorandil 36 hours after surgery.The following parameters were measured:TIMI grade,corrected TIMI frame count(c TFC),TIMI myocardial perfusion grade(TMPG),STsegment resolution(STR)rate 2 hours post-operatively,resolution of ST-segment elevation(STR)at 2 hours postoperatively,peak level of serum CK-MB,left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)at 7–10 days postoperatively,and major adverse cardiac events(MACEs)in-hospital and within 30 days post-operatively.RESULTS:Compared with the control group,more patients in the treatment group had TIMI 3 and TMPG 3,and STR after PCI was significantly higher.The treatment group also had significantly lower c TFC,lower infarction relative artery(IRA),lower peak CK-MB,and no reflow ratio after PCI.The treatment group had significantly higher LVEDD and LVEF but lower incidence of MACEs than the control group.CONCLUSION:The intracoronary injection of nicorandil combined with tirofiban can effectively improve myocardial reperfusion in elderly STEMI patients after emergency PCI and improve shortterm prognoses.

Early prediction of myocardial viability after acute myocardial infarction by two-dimensional speckle tracking imaging

Background Identifying the transmural extent of myocardial necrosis and the degree of myocardial viability in acute myocardial infarction （AMI） is important clinically. The aim of this study was to assess myocardial viability using two-dimensional speckle tracking imaging （2D-STI） in patients with AMI. Methods 2D-STI was performed at initial presentation, three days, and six months after primary percutaneous coronary intervention （PCI） in 30 patients with AMI, who had a left anterior descending coronary artery （LAD） culprit lesion. In addition, 20 patients who had minimal stenotic lesions （〈 30% stenosis） on coronary angiography were also included in the control group. At six months dobutamine echocardiography was performed for viability assessment in seven segments of the LAD territory. According to the recovery of wall motion abnormality, segments were classified as viable or non-viable. Results A total of 131 segments were viable, and 44 were nonviable. Multivariate analysis revealed significant differences between the viable and nonviable segments in the peak systolic strain, the peak systolic strain rate at initial presentation, and peak systolic strain rate three days after primary PCI. Among these, the initial peak systolic strain rate had the highest predictive value for myocardial viability （hazard ratio： 31.22, P 〈 0.01）. Conclusions 2D-STI is feasible for assessing myocardial viability, and the peak systolic strain rate might be the most reliable predictor of myocardial viability in patients with AMI.

Associations of Infarct Size and Regional Myocardial Function Examined by Cardiac Magnetic Resonance Feature Tracking Strain Analysis with the Infarct Location in Patients with Acute ST-Segment Elevation Myocardial Infarction

Objective To quantitatively evaluate the associations of infarct size,regional myocardial function examined by cardiac magnetic resonance feature tracking(CMR-FT)strain analysis with infarct location in patients with ST-segment elevation myocardial infarction(STEMI)treated by primary percutaneous coronary intervention.Methods Cardiac magnetic resonance images were retrospectively analyzed in 95 consecutive STEMI patients with successful reperfusion.The patients were divided into the anterior wall myocardial infarction(AWMI)and nonanterior wall myocardial infarction(NAWMI)groups.Infarct characteristics were assessed by late gadolinium enhancement.Global and regional strains and associated strain rates in the radial,circumferential and longitudinal directions were assessed by CMR-FT based on standard cine images.The associations of infarct size,regional myocardial function examined by CMR-FT strain analysis with infarct location in STEMI patients were evaluated by the Spearman or Pearsonmethod.Results There were 44 patients in the AWMI group and 51 in the NAWMI group.The extent of left ventricular enhanced mass was significantly larger in patients with AWMI compared with the NAWMI group(24.47±11.89,21.06±12.08%LV;t=3.928,P=0.008).In infarct zone analysis,strains in the radial,circumferential and longitudinal directions were remarkably declined in the AWMI group compared with the NAWMI group(z=-20.873,-20.918,-10.357,all P<0.001).The volume(end-systolic volume index),total enhanced mass and extent of enhanced mass of the left ventricular were correlated best with infarct zone strain in the AWMI group(all P<0.001).Conclusion In STEMI patients treated by percutaneous coronary intervention,myocardial damage is more extensive and regional myocardial function in the infarct zone is lower in the AWMI group compared with the NAWMI group.

The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/contemporary cardiac troponin for the early diagnosis of acute myocardial infarction

BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(c Tn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the c Tn assays:the point-of-care c Tn(POC-c Tn)group,the contemporary c Tn(c-c Tn)group,and hs-c Tn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-c Tn/c-c Tn assays,combining CK-MB and POC-c Tn/c-c Tn increased the diagnostic sensitivity of AMI(56.1%vs.63.9%,P<0.001;82.7%vs.84.3%,P=0.025).In contrast,combining CK-MB and hs-c Tn did not change the sensitivity compared with hs-c Tn alone(95.0%vs.95.0%,P>0.999).In the subgroup analysis,the sensitivity of combining CKMB and c-c Tn increased with time from symptom onset<6 h compared with c-c Tn alone(72.8%vs.75.0%,P=0.046),while the sensitivity did not increase with time from symptom onset>6 h(97.5%vs.98.3%,P=0.317).The AUC of the combination of CK-MB and POC-c Tn significantly increased compared to the single POC-c Tn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CKMB and c-c Tn/hs-c Tn assays did not significantly decrease compared with that of the single c-c Tn/hs-c Tn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-c Tn or c-c Tn may be valuable for the early diagnosis of AMI,especially when hs-c Tn is not available.

Factors influencing prehospital delay for patients with acute myocardial infarction

Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI). Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.

The impact of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention

Objective To investigate the effects of different doses of atorvastatin on plasma endothelin and platelet function in acute ST-segment elevation myocardial infarction(STEMI)patients after emergency percutaneous coronary intervention(PCI).Methods A total of 120 patients with acute STEMI treated with emergency PCI were enrolled and randomly divided into 20 mg of atorvastatin treatment group(standard group,n=60),and 40 mg of atorvastatin treatment group(intensive group,n=60).

Application effect of optimized emergency nursing process in the rescue of patients with acute myocardial infarction

Background Acute myocardial infarction is a common and prevalent cardiovascular disease that can lead to serious consequences such as shock,arrhythmia,and heart failure.In dealing with acute myocardial infarction,the optimization of emergency nursing process can ensure the effectiveness and safety of rescue work,and help improve the prognosis and rehabilitation of patients.Methods 68 cases of patients with acute myocardial infarction admitted to our hospital from August 2021 to March 2023 were selected as the subjects of this study.They were randomly divided into an observation group and a control group,with 34 cases in each group.The control group received routine nursing care,while the observation group received optimized emergency nursing process based on it.the success rates of rescue,emergency efficiency,complications,and hemodynamics were compared between the two groups.ResultsThe success rate of rescue in the observation group was 100.00%,while in the control group it was 88.24%,the success rate of rescue was statistically different between the two groups(P<0.05).The observation group had shorter time intervals from onset to hospital admission,shorter door-to-activation time,shorter door-toballoon time,and reduced length of hospital stay compared to the control group(P<0.05).The total proportion of patients with complications such as arrhythmias in the observation group was 0.00%,while in the control group it was 11.76%,the difference between the two groups was statistically significant(P<0.05).The Cardi-ac output(CO)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is higher than the control group.The Mean arterial pressure(MAP)index of the observation group and the control group is lower than before the nursing intervention,and the observation group is lower than the control group(P<0.05).Conclusions Optimized the emergency nursing process can improve the success rate of rescue and emergency efficiency in patients with acute myocardial infarction,reduce the occurrence of adverse complications,and improve negative emotions such as anxiety.It is worth promoting and applying.

基于时间节点为导向的院内快速急救模式在急性心肌梗死中的应用

目的 分析基于时间节点为导向的院内快速急救模式在急性心肌梗死(AMI)应用方面的效果。方法 挑选2020年1月—2021年6月新疆医科大学第一附属医院治疗的AMI患者597例设为对照组,实施常规急救护理干预,选取2021年7月—2022年12月急诊收治的597例AMI患者设为观察组,实施基于时间节点为导向的院内快速急救模式干预。比较两组救治流程时间、心肌酶谱水平、抢救效果及护理满意度情况。结果 观察组分诊时间、完成院内首份心电图时间、急诊球囊开通时间、急诊室停留时间、经皮冠状动脉介入(PCI)术治疗时间均比对照组短(P<0.05)。出院前1 d观察组心肌酶谱指标心肌肌钙蛋白(cTnT)和肌酸激酶同工酶(CKMB)水平均比对照组低(P<0.05)。观察组住院时间比对照组短(P<0.05),并发症出现的概率及病死率方面,观察组(分别为3.69%、1.68%)均比对照组(11.22%、7.71%)低(P<0.05)。观察组护理总满意度(95.64%)比对照组(79.06%)高(P<0.05)。结论 基于时间节点为导向的院内快速急救模式在了AMI患者救治过程中能有效缩短各个救治流程时间,减少心肌损伤,提升救治效果及护理满意度,改善患者预后。

急诊PCI联合体外膜肺氧合在抢救急性心肌梗死后心脏骤停患者中的临床效果

目的分析急诊经皮冠状动脉介入治疗(PCI)联合体外膜肺氧合(ECMO)在抢救急性心肌梗死后心脏骤停患者中的应用效果.方法选取本院2021年1月—2023年2月收治的70例急性心肌梗死后心脏骤停患者为研究对象,根据抢救方法将其分为对照组与观察组,每组35例.对照组采用急诊PCI联合常规心肺复苏治疗,观察组采用急诊PCI联合ECMO治疗.比较两组患者的自主循环恢复率、意识状态、格拉斯哥-匹兹堡脑功能表现分级及生存率.结果观察组自主循环恢复率为100%,高于对照组的85.71%,差异有统计学意义(P<0.05).术后1、3 d,观察组GCS评分均高于对照组,组间差异有统计学意义(P<0.05).观察组格拉斯哥-匹兹堡脑功能表现分级≤2级发生率高于对照组,>2级发生率低于对照组,组间差异有统计学意义(P<0.05).观察组随访1年生存率为97.14%,高于对照组的85.71%,差异有统计学意义(P<0.05).结论急诊PCI联合体外膜肺氧合治疗急性心肌梗死后心脏骤停有着较高抢救成功率,改善脑功能,提高生存率,值得推广.

血栓抽吸联合替罗非班对急性ST段抬高型心肌梗死急诊冠脉介入治疗的效果分析

目的 探究对急性ST段抬高型心肌梗死急诊冠脉介入治疗患者施以血栓抽吸联合替罗非班的作用。方法 方便选取2021年1月—2023年8月呼和浩特市第一医院收治的72例急性ST段抬高型心肌梗死行急诊冠脉介入治疗的患者作为研究对象,根据不同治疗方法将其分为两组,各36例。对照组采用替罗非班治疗,研究组血栓抽吸联合替罗非班治疗,比较两组心功能相关指标、治疗效果、不良反应、远期非致死性心肌梗死发生率、心源性病死率。结果 研究组心功能改善优于对照组,远期非致死性心肌梗死发生率和心源性病死率低于对照组,差异有统计学意义(P均<0.05)。研究组不良反应发生率为8.33%(3/36),低于对照组的27.78%(10/36),差异有统计学意义(χ^(2)=4.600,P<0.05)。结论 在急性ST段抬高型心肌梗死急诊冠脉介入治疗时,对患者进行血栓抽吸联合替罗非班治疗,效果显著,具有临床价值。

基于急救护理质量构建急性心肌梗死患者急救流程护理方案及其急救效果初探

目的 研究基于急救护理质量构建急性心肌梗死患者急救流程护理方案及其急救效果。方法 本研究以2020年1月—2021年12月在新疆医科大学第一附属医院进行治疗的急诊心肌梗死患者150例作为研究对象,新疆医科大学第一附属医院于2021年开展基于流程优化构建急救护理环节管理,其中2020年(对照组)以及2021年(观察组)各入选75例,比较两组患者的抢救情况、心功能指标、不良心脑血管事件发生情况、护理服务能力、护理满意度进行比较。结果 观察组患者的抢救成功率(χ^(2)=5.372,P=0.020)显著高于对照组,急诊停留时间(t=5.264,P=0.000)、完成首份心电图时间(t=16.583,P=0.000)、完成肌钙蛋白检查时间(t=17.881,P=0.000)、住院时间(t=4.849,P=0.000)显著低于对照组,观察组患者治疗后10天、3个月以及6个月的LVEF、LVED显著优于对照组(P<0.05);观察组患者的治疗后6个月内发生心肌梗死复发、靶血管血运重建、心力衰竭发生率显著低于对照组;观察组对于护理人员专业知识评分(t=14.375,P=0.000)、快速反应能力评分(t=4.300,P=0.000)、医护配合评分(t=10.171,P=0.000)显著高于对照组,观察组患者的护理满意度显著高于对照组(P<0.05)。结论 基于本院实际情况的护理质量评价体系的构建,对于急性心肌梗死患者急救效果的提升具有积极的意义,建议临床推广。

多模态影像对STEMI患者急诊PCI术后MACE的预测价值

目的:探讨三维斑点追踪超声心动图(three-dimensional speckle tracking echocardiography,3D-STE)、心肌做功(myo-cardial work,MW)对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者急诊经皮冠状动脉介入治疗(primary percutaneous coronary intervention,PPCI)术后主要不良心血管事件(major adverse cardiovascular event,MACE)发生的预测价值。方法:纳入90例行PPCI的首次STEMI患者,术后24 h内行3D-STE、MW检查,术后7 d内完善心脏磁共振晚期钆增强成像(cardiac magnetic resonance late gadolinium enhancement imaging,CMR-LGE)检查,随访12个月MACE(再发心绞痛、因急性冠脉综合征行血运重建、急性心衰发作、心源性猝死)的发生情况。结果:20例(22.2%)患者发生MACE,单因素及多因素Cox回归分析显示梗死面积(infarction size,IS)、整体纵向应变(global longitudinal strain,GLS)、整体做功指数(global work index,GWI)为预测MACE发生的独立参数,受试者工作特征(receiver operating characteristic,ROC)曲线显示上述指标的曲线下面积(area under the curve,AUC)分别为0.886、0.846、0.830,Delong法两两比较显示AUC值差异无统计学意义(P均>0.05)。联合GLS和GWI预测MACE发生的AUC值达0.939,显著优于GLS及GWI单一参数(P均<0.05),且与IS相当(P>0.05)。Kaplan-Meier曲线表明GLS<-10.5%、GWI>1298.5 mmHg%、IS<26.05%的患者有更高的生存率(P<0.05)。结论:3D-STE及MW能较好地预测STEMI患者PPCI术后MACE的发生,其中GLS及GWI诊断价值相似,二者联合优于单一指标,且与IS诊断效能相当。

急性心肌梗死患者经皮冠状动脉介入术后心力衰竭的预测模型及效能评价

目的基于心肌做功超声显像技术建立急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入(PCI)术后新发心力衰竭的预测模型。方法回顾性纳入2021年1月至2023年3月金华市中心医院确诊AMI并接受急诊PCI患者193例,出院后常规随访6个月,根据左心室射血分数(LVEF)<50%分为心力衰竭组31例和无心力衰竭组162例。比较两组患者临床资料、常规超声检测指标[左心室舒张末内径(LVEDd)和左心室舒张末容积(LVEDV)、左心室收缩末内径(LVESd)和左心室收缩末容积(LVESV)]、二维斑点追踪参数整体纵向应变(GLS)及心肌做功参数[整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)和整体做功效率(GWE)]。采用最小绝对收缩和选择算法(LASSO)和多因素logistic回归筛选影响因素,构建列线图预测模型,Bootstrap法计算一致性指数,绘制ROC曲线计算AUC,采用校准曲线和决策曲线进行预测效能验证。结果与无心力衰竭组比较,心力衰竭组年龄、峰值肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、GLS和GWW均增加,而完全血运重建率、GWI、GCW、GWE均降低(均P<0.05)。LASSO回归和多因素logistic回归分析显示,峰值cTnI、GLS和GWW是AMI患者急诊PCI术后6个月新发心力衰竭的危险因素,而GWI是保护因素(均P<0.05)。Bootstrap法计算列线图一致性指数为0.856;ROC曲线分析列线图模型的AUC为0.893(95%CI:0.842~0.935,P<0.001),提示列线图模型的预测效能较好;校准曲线显示有较好的吻合度,决策曲线显示有较好的临床净获益比。结论AMI患者急诊PCI术后仍有一定的新发心力衰竭风险,二维超声斑点追踪和无创心肌做功超声显像技术能够较好地评估心肌舒缩功能;列线图模型对指导临床早期识别新发心力衰竭的高危人群具有重要的实践价值。

冠状动脉内注射重组人尿激酶原在急诊经皮冠状动脉介入治疗中的效果分析

目的探讨注射用重组人尿激酶原冠状动脉内注射在急诊经皮冠状动脉介入术(PCI)的急性ST段抬高型心肌梗死(STEMI)患者中应用的临床价值。方法采用回顾性分析方法,收集2019年1—12月心内科行急诊PCI术的STEMI患者,按照术中患者在支架植入前经指引导管靶向注射药物的不同,分为替罗非班组(70例)与重组人尿激酶组(70例),比较2组患者TIMI血流分级、梗死相关动脉ST段回落值(STR)、血浆D-二聚体、左室射血分数(LVEF)及冠状动脉微循环功能障碍,记录2组患者一般资料及主要不良心血管事件(MACE)及出血情况等。结果与替罗非班组比较,重组人尿激酶原组患者TIMI血流水平、LVEF、血浆D-二聚体、STR≥70%患者比例均明显升高,而慢血流/无复流与MACE发生率明显降低,差异有统计学意义(P<0.05)。重组人尿激酶原组出血事件发生率有降低趋势,但2组差异无统计学意义(P>0.05)。结论经指引导管冠状动脉内注射重组人尿激酶原可显著改善STEMI患者的心肌血流灌注和预后,降低不良心血管事件,安全系数高,值得临床推广。

心脏磁共振成像整体纵向应变对急性ST段抬高型心肌梗死后左心室重构的预测价值:403例前瞻性研究

目的 分析心脏磁共振成像(CMR)特征追踪技术测量的整体纵向应变(GLS)对急性ST段抬高型心肌梗死(STEMI)患者接受经皮冠状动脉介入治疗后(PCI)左心室重构(LVR)的预测价值。方法 前瞻性纳入来自国内多中心的经PCI术后的STEMI患者共403例,分别于心肌梗死后1周(7±2 d)和6月进行CMR检查,获得GLS、整体径向应变(GRS)、整体周向应变(GCS)、射血分数(LVEF)和心肌梗死面积(IS)。主要终点为LVR,其定义是随访中通过CMR检查左心室舒张末期容积从基线到6月增加≥20%或左心室收缩末期容积增加≥15%,根据LVR的发生情况将患者分为LVR组(n=101)和无LVR组(n=302)。采用Logistic回归分析CMR参数对LVR的预测价值。结果 与无LVR组相比,LVR组的GLS、GCS更大(P<0.001),GRS、LVEF更小(P<0.001)。Logistic回归分析显示,GLS(OR:1.387,95%CI:1.223~1.573,P<0.001)和LVEF(OR:0.951,95%CI:0.914~0.990,P=0.015)是LVR的独立预测因子。ROC曲线分析显示,GLS预测LVR的最佳临界值为-10.6%,灵敏度为74.3%,特异度为71.9%。GLS预测LVR的AUC与LVEF的差异无统计学意义(P=0.146),但优于GCS、GRS和IS等其他参数(P<0.05)。LVEF与其他参数的AUC差异无统计学意义(P>0.05)。结论 基于CMR测定的GLS是STEMI患者PCI术后LVR的重要预测因子,与GRS、GCS、IS和LVEF相比具有明显的优势。

急性心肌梗死病人复苏工作延迟风险及救治效果

目的:探讨影响急性心肌梗死(AMI)病人复苏工作延迟的影响因素,并确定其对急诊科救治效率及治疗时机的影响。方法:回顾性调查2020年1月1日—2022年1月1日在安徽省合肥市某三级甲等医院急诊科就诊的急性心肌梗死病人,调查病人的一般资料、急诊拥挤指标、急诊生命体征、急诊救治相关指标等,分析急性心肌梗死病人复苏工作延迟的影响因素。结果:共纳入753例急性心肌梗死病人,其中复苏工作延迟组228例,占30.3%。年龄、急诊主诉、入院方式、就诊时间、经皮血氧饱和度、改良早期预警评分是心肌梗死病人复苏工作延迟的影响因素。复苏工作延迟组急诊滞留时间长于非复苏工作延迟组,经皮冠状动脉介入治疗、门球时间达标比例低于非复苏工作延迟组(P<0.05)。结论:年龄<45岁、主诉胸闷及其他症状群、自行入院、夜间就诊为急性心肌梗死病人发生复苏工作延迟独立危险因素,复苏工作延迟可能会导致急性心肌梗死病人错过最佳治疗时机而影响急诊救治效果。

PERMA模式护理干预对急诊经皮冠脉介入术后患者运动恐惧和心理弹性的效果

目的探讨PERMA模式护理干预对急性心肌行经皮冠脉介入(PCI)术后患者运动恐惧和心理弹性的影响。方法选取160例急诊PCI术后患者为研究对象,随机分为对照组(80例)和观察组(80例)。对照组予以常规护理,观察组在常规护理的基础上实施基于PERMA模式护理干预。在入院第2天和干预6周后采用运动恐惧量表和心理弹性量表进行效果评价。结果护理干预6周后,观察组TSK-Heart-C量表的害怕受伤、自身功能下降、避免运动、感知到心脏危险4个得分及总分均明显降低,且观察组干预6周后的总分低于对照组,P<0.05。护理干预6周后,观察组CD-RISC量表中坚韧、自强、乐观维度得分及总分均增加,P均<0.05,且观察组上述得分均高于对照组,P<0.01。结论PERMA模式护理干预可以有效的降低患者运动恐惧程度,提高心理弹性水平,对改善急诊PCI术后患者心脏康复具有重要意义。

优化急诊护理流程对急性心肌梗死患者的救治效果及对其焦虑、抑郁情绪的影响

目的探究急性心肌梗死患者应用优化急诊护理流程的救治效果及对其焦虑、抑郁情绪的影响。方法选取2022年8月至2023年8月乐安县人民医院收治的92例急性心肌梗死患者为研究对象,根据随机单双号分组法分为试验组(46例)和常规组(46例),分别采用不同的护理流程,对急救效果及患者的不良情绪进行对比分析。结果试验组患者各项就诊救治指标所用时间均短于常规组(P<0.05)。试验组患者抢救成功率为95.65%、高于常规组的78.26%,急性心肌梗死复发率为6.52%、再行手术治疗率为2.17%,分别低于常规组的21.74%和13.04%(P<0.05)。护理前,试验组患者焦虑、抑郁评分与常规组患者比较无明显差异(P>0.05)。护理后,试验组患者焦虑和抑郁评分显著低于常规组(P<0.05)。结论急性心肌梗死患者在急诊抢救时,优化急诊护理流程,能够使久之效果得到显著提升,还能有效改善焦虑、抑郁情况。

基于循证的急诊护理流程在急性心肌梗死患者抢救中的应用效果

目的探讨基于循证的急诊护理流程应用于急性心肌梗死患者抢救的效果。方法选取2022年8月至2023年8月在河南省胸科医院就诊的120例急性心肌梗死患者。将2022年8月至2023年2月接诊的60例患者作为对照组,给予常规急救护理;将2023年3—8月接诊的60例患者作为观察组,给予基于循证的急诊护理流程。比较两组患者的急诊抢救时间、抢救成功率、心肌梗死复发率及护理满意度。结果观察组患者静脉通路建立时间、心电图检查时间、静脉采血时间、入院-会诊时间及会诊-导管室时间短于对照组(P<0.05);观察组抢救成功率高于对照组,心肌梗死复发率低于对照组(P<0.05);观察组护理满意度高于对照组(P<0.05)。结论基于循证的急诊护理应用于急性心肌梗死患者的抢救,可缩短抢救时间,提高抢救成功率,有效降低心肌梗死的复发率,促进护理满意度的提升。

1例急性心肌梗死患者急诊经皮冠状动脉介入治疗术后并发亚急性心脏破裂的护理体会

本文总结1例急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)术后并发亚急性心脏破裂的救治及护理经验。针对患者危重症状,早期快速识别和诊断,及时采取急救处理,加强病情观察和护理配合,控制患者不适症状,有效降低心脏破裂的风险,为患者的生命安全提供保障。