心区交感神经阻滞治疗急性心肌梗死泵衰竭  

Effect of cardiac sympathetic nerve blockade on acute myocardial infarction associated with pump failure

作　　者：孙桂芳[1] 刘凤岐[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院心内科,黑龙江省哈尔滨150001

出　　处：《中华急诊医学杂志》2005年第10期836-838,共3页Chinese Journal of Emergency Medicine

基　　金：黑龙江省"十五"科技攻关项目(GB01C126-03)

摘　　要：目的评价心区交感神经阻滞(CSNB)治疗急性心肌梗死(AMI)泵衰竭疗效。方法AMI泵衰竭患者43例,随机分为治疗组22例,对照组21例。治疗组除行CSNB及手术当天停用抗血小板、抗凝药物外,其他药物处置与对照组相同。观察治疗后生命体征变化、心力衰竭症状、体征缓解及心脏功能改善情况。结果治疗30min后,两组呼吸频率、收缩压下降(P<0.05);治疗组心率降低(P<0.05),对照组无显著变化(P>0.05)。治疗15min、30min、60min后,治疗组分别有12例、17例、21例心力衰竭症状与体征缓解、对照组对应分别为2例、8例、18例,两组比较差异有显著性(P<0.01)。治疗24h后,治疗组总有效率高于对照组(96%VS.62%,P<0.05)。结论CSNB治疗AMI泵衰竭,起效快、疗效佳。Objective To evaluate the effect of cardiac sympathetic nerve blockade （CSNB） on acute myocardial infarction （AMI） associated with pump failure. Methods Forty-three patients with AMI and pump failure were randomly divided into two groups., treatment group （ n = 22） and control group （ n = 21 ） . CSNB was administered to patients in treatment group, with the operation day the other treatment was the same as that in control group without antleoagulation drugs. After treatment, the change of vital signs, the improvement of clinical symptom or signs and cardiac function were observed. Results Thirty minutes after treatment, breathing rate and systolic blood pressure were decreased in the two groups （ P 〈 0.05）. Heart rate decreased in treatment group （ P 〈 O. 05）, but didn＇t change in the control group （ P 〉 0.05）. Fifteen minutes, 30 minutes and 60 minutes after treatment, 12 patients, 17 patients and 21 patients in the treatment group, respectively, showed improvement of clinical symptom or signs, with only 2, 8 and 18 in the control group. The difference was signfieant （ P 〈 0.01 ）. Twenty-four hours after treatment, the total effective ratio was higher in treatment group than that in the control group （96 % VS. 62 %, P 〈 0.05 ）. Conclusion CSNB is quick and effective in treatment of AMI accompanied with pump failure.

关 键 词：心区交感神经阻滞 急性心肌梗死 泵衰竭 硬膜外麻醉 溶栓治疗 

分 类 号：R542.22[医药卫生—心血管疾病]