急性心肌梗死并过缓心律失常时应用床旁紧急临时起搏的体会  

Application of bedside temporary cardiac pacing to the patients with bradyarrhythmia and acute myocardial infarction

作　　者：黄新平 洪云飞[2] 张荣华[2] 李慧娟 孙琳 刘帆 杨红玲 

机构地区：[1]云南省第三人民医院心内科,昆明650011 [2]云南省第二人民医院心内科,昆明650021

出　　处：《中国急救医学》2009年第2期131-133,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨床旁紧急临时起搏在抢救急性心肌梗死（AMI）并过缓性心律失常时的作用。方法将175例AMI并过缓性心律失常患者分为起搏组（P组）91例和非起搏组（NP组）84例，比较两组在入院30d时的死亡率、溶栓例数、梗死相关血管（IRA）开通率、再发心脏事件（包括心肌梗死及心绞痛等）和并发症等方面的差异。结果总死亡率为28．00％（49／175），其中P组死亡率为17．58％（16／91），NP组为39．29％（33／84），两组差异有统计学意义（P〈0．01）；溶栓例数：P组82例（90．11％），NP组61例（72．62％），两组差异有统计学意义（P〈0．01）；IRA开通率：两组差异无统计学意义[P组65．85％（54／82）和NP组57．38％（35／61），P〉0．05]；再发心脏事件：P组9．89％（9／91），NP组25．00％（21／84），两组差异有统计学意义（P〈0．01）。两组均无（包括严重出血在内的）并发症。结论床旁紧急临时起搏救治AMI并过缓心律失常有益并且安全。Objective To evaluate the effects of bedside temporary cardiac pacing on the patients with bradyarrhythmia and acute myocardial infarction（AMI）. Methods 175 patients with bradyarrhythmia and AMI were divided into cardiac pacing group（ P group, n = 91 ） and non - cardiac pacing group （ NP group, n = 84 ）. 30 - day mortality, the number of patients received intravenous thrombolysis and patency rate of infarct - related artery （ IRA } , recurrent cardiac events such as recurrent myocardial infarc- tion and angina pectoris were compared between two groups. Results Total mortality was 28.00% （49/ 175）. Mortality in P group was significantly lower than that in NP group[ 17.58% （ 16/91 ） vs 39.29% （33/84） , P 〈0.01 ]. The number of patients received intravenous thrombolysis in P group was signifi- cantly more than that in NP group[ 90.11% （82/91） vs 72.62% （61/84）, P 〈 0.01 ]. IRA patency rates was not significantly different in the two groups [ P ：65.85 % （ 54/82） vs NP ： 57.38% （ 35/61 ）, P 〉 0.05 ] and recurrent cardiac events in P group was significantly lower than that in NP group[9, 89% （9/91 ） vs 25, 00% （21/84）, P 〈0.01 ]. Complications including severe bleeding did not oecur in the two groups. Conclusions Bedside temporary cardiac pacing in treating patients with bradyarrhythmia and acute myoeardial infarction is effective and safe.

关 键 词：临时起搏 急性心肌梗死 过缓性心律失常 死亡率 

分 类 号：R542.22[医药卫生—心血管疾病]