老年人急性心肌梗塞的冠脉造影特点与护理  

The features of the coronary angiography and nursing for elderly patients with the acute myocardial infarction

作　　者：刘继英[1] 薛艳[1] 吴玉丽[1] 

机构地区：[1]山东省立医院介入中心,山东济南250021

出　　处：《医学影像学杂志》2006年第2期194-196,共3页Journal of Medical Imaging

摘　　要：目的：探讨老年人急性心肌梗塞（AMI）冠脉造影（CAG）的特点及发病机制和围造影期的并发症，以指导临床治疗与护理。方法：1998年12月～2003年2月间老年人AMI564例，入选病例均为发病后12h内先给予溶栓和抗凝治疗，后行CAG。梗塞相关动脉（IRA）根据狭窄程度按Proudilit分级法。结果：CAG显示564例中病变血管狭窄〈50％者74例（13．2％），次全梗阻和完全闭塞病变415例（73．7％）；双支病变409例（72．5％）；病变血管狭窄〉75％者有394例（69．8％）454处病变即刻或择期行介入治疗，其成功率为100％。围造影期常见并发症为低血压、迷走反射、对比剂反应、室颤、动脉夹层等。结论：老年人急性心肌梗塞以多支病变为多。以严重狭窄和闭塞病变为主，发病机制主要为粥样斑块基础上的血栓形成；围造影期常见的并发症低血压、对比剂反应、迷走反射等早期发现、及时处理可迅速缓解。Objective： To investigate the features of the coronary angiography （CAG） results and the complications in periangiography period for eldedy patients with the acute myocardial infarction （AMI）.Methods：CAG were undergone in 564 elderly AMI, who received thrombolytic and anticoagulative therapy within 12 hours from the onset of AMI. The infarction relevant artery （IRA） were classified according to the degree of stenosis with Proudilit classification pricinple. Results： CAG showed that stenosis degree of the artery in 74 cases is less than 15%, that subocclusion and total occlusion in 415 cases, single brunch lesion in 111 cases, double branch lesion in 409 cases, tribmnch lesion in 44 cases and left main tmnck lesion in 58 cases. Conclusion：Elder of AMI was multi-branch of coronary artery envolved, with the feature of severe stenosis and blockage. The mechanism is thrombosis formation based on atheromatous plaque. The complications of periangiography was hypotension, contrast reaction and vagal reflects, which disappeared rapidly after properly management.

关 键 词：急性心肌梗塞 冠状动脉造影 梗塞相关动脉 护理 

分 类 号：R542.2[医药卫生—心血管疾病] R815[医药卫生—内科学]