非ST段抬高心肌梗死抗血小板和抗凝治疗的循证护理研究  

Study of Platelet Antagonists and Hypomolecular Heprin to Acute Non-ST Elevation Myocardial Infarction on the Basis of Evidence-based Nursing

作　　者：徐冬梅[1] 贾延莹[1] 王建文[1] 周叶英[1] 

机构地区：[1]山东省千佛山医院内科,山东省济南市250014

出　　处：《实用心脑肺血管病杂志》2009年第11期942-944,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的按循证护理学要求,观察阿司匹林、氯吡格雷和低分子肝素治疗急性非ST段抬高心肌梗死(NSTEMI)的安全性,提供NSTEMI的循证护理方法。方法急性NSTEMI患者76例,以阿司匹林、氯吡格雷、低分子肝素及抗心绞痛药物治疗。在中国医院数字图书馆网络搜集有关服药、注射、护理的循证护理资料。阿司匹林首次顿服300 mg,次日起100mg/d,连服2周;氯吡格雷首次顿服300 mg,次日起75 mg/d,连服2周。低分子肝素钠0.4ml,皮下注射,每12h 1次,连用7 d。结果治疗后患者的临床症状明显改善,且对凝血指标影响不大,活化部分凝血活酶时间仅由(35±4.1)s延长到(38±5.2)s。低分子肝素的循证注射方法所致皮肤局部反应情况与传统注射方法比较,差异有统计学意义(P<0.05)。结论在常规抗心绞痛治疗基础上加用抗血小板和抗凝药物治疗NSTEMI安全有效;因抗凝和抗血小板药物会引起出血,对这类患者要加强护理。Objective To observe the clinical safety in treatment of non - ST elevation myocardial infarction （ NSTEMI） with platelet antagonists and hypomolecular heprin on the basis of evidence - based nursing. Methods 76 patients with acute NSTEMI were treated with aspirin, clopidogrel and hypomolecular heprin as well as anti - anginal drugs. Searching on the net of China National Knowledge [nfrastructure to retrieve useful data. The initial doses of aspirin are 300 mg and followed 100 mg/d for two weeks. The initial doses of clopidogrel are 300 mg and followed 75 mg/d for two weeks. The remedy of hypomolecular heprin is 0. 4 ml every 12hours for 7d. Results Clinical symptoms and isehemic ST segment depression were improved, and had a small influence on index of blood clotting （P 〈0.05）, that is APTT prolongs from 35 ±4. 1 to 38±5.2 seconds. The reforming injection method of hypomolecular heprin is much better than the traditional one. Conclusion Therapy of platelet antagonists and hypomolecular heprin would be more effective and safety to NSTEMI. Because of there bleeding side effects we should enhance the nursing to non -ST elevation myocardial infarction patients.

关 键 词：氯吡格雷 抗血小板药物 肝素 非ST段抬高心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]