急性心肌梗死心肺复苏后静脉溶栓16例临床护理  

Clinical nursing care in the treatment of 16 patients with acute myocardial infarction with thrombolysis after cardiopulmonary resuscitation

作　　者：李洪英[1] 周秀花[1] 

机构地区：[1]山东省千佛山医院,山东济南250014

出　　处：《齐鲁护理杂志（下旬刊）》2010年第7期13-15,共3页Journal of Qilu Nursing

摘　　要：目的：探讨急性心肌梗死（AMI）患者心肺复苏（CPR）成功后静脉溶栓过程中的护理。方法：选择本院急诊科急性心肌梗死病例16例，在入院后0．5～3h发生心脏骤停，经心肺复苏成功后均行静脉溶栓治疗，护士密切配合并观察其临床效果。结果：16例患者心脏骤停至开始CPR时间〈5min，人均除颤3．2次，均行胸外按压。自主循环恢复（ROSC）时间〈30min14例，冠状动脉再通14例，溶栓后出血2例（12．5％），与国内大型AMI溶栓试验（11．1％）相比，出血发生率未见显著升高（P〉0．05）。结论：对于AMI心脏骤停时间〈5min、30min内恢复自主循环的AMI患者与心肺复苏复苏成功的患者行静脉溶栓治疗时，护士精湛的急救技术、严密的观察、精心的护理、细致的心电监护及防治并发症是溶栓成功的关键。Objective： To explore the nursing care in the thrombolysis for the patients with acute myocardial infarction （ AMI ） after successful eardiopulmonary resuscitation （ CPR ）. Methods ： 16 AMI patients （ cardiac arrest within O. 5 - 3 hours after admission） in the emergency department were treated with intravenous thrombolytic therapy after successful cardiopulmo- nary resuscitation, the close cooperation was provided by nurses and clinical effect was observed. Results： The time from cardi- ac arrest to the beginning of CPR was less than 5 minutes in the 16 patients, who were given defibrillation 3.2 times averagely and chest compression was performed. The time of restoration of spontaneous circulation （ROSC）in 14 patients was less than 30 minutes. 14 patients had coronary artery recanalization 2 patients had hemorrhage after thrombolysis （ 12.5% ） and the inci- dence of hemorrhage was not significantly higher （ P 〉 0.05 ） compared with domestic large - scale AMI thrombolytie trials （ 11. 1% ）. Conclusion： For the AMI patients who had cardiac arrest less than 5 minutes and had ROSC within 30 minutes, nurses＂ skilled first - aid technique, close observation, meticulous nursing care, careful ECG monitoring and prevention of complications are very important to ensure the success of thrombolysis when the patients were treated with intravenous thrombolytic therapy after successful CPR.

关 键 词：急性心肌梗死 心肺复苏 静脉溶栓 护理 

分 类 号：R473.5[医药卫生—护理学]