参附快速静脉滴注与多巴胺泵入在急性下壁心肌梗死介入治疗中的应用对比  

Comparison between rapid intravenous drip of Shenfu and pumping of Dopamine in interventional therapy of acute inferior wall myocardial infarction

作　　者：张冬梅[1] 王丽华[2] 孙东绣 孙常磊[3] 都丽丽[3] 姚克兢[3] 刘瑶[3] 于兴才[3] 

机构地区：[1]山东省烟台市烟台山医院心导管室,264008 [2]山东省烟台市烟台山医院质控室,264008 [3]山东省烟台市烟台山医院护理部,264008

出　　处：《中华现代护理杂志》2017年第18期2383-2387,共5页Chinese Journal of Modern Nursing

基　　金：2016年度烟台市重点研发计划（2016WS064）

摘　　要：目的比较参附加压快速静脉滴注与多巴胺微量泵人改善急性下壁心肌梗死PCI术中低灌注的效果。方法采用便利抽样法，选择2014年5月-2016年5月烟台市烟台山医院胸痛中心急诊行PCI术的急性下壁心肌梗死患者80例，按随机数字表法分为观察组和对照组，每组各40例，观察组给予0．9％氯化钠溶液加参附快速加压静脉滴注，对照组给予0．9％氯化钠溶液同等压力加压静脉滴注并多巴胺微量泵人，观察记录两组用药前、用药后5-40min内每5分钟血压、心率，用药后恶性心律失常、呕吐发生率，TIMI3级血流比例以及随访30d后主要不良心血管事件发生率。结果两组患者用药后收缩压、舒张压、平均动脉压均能达到并维持至期望值，两组比较差异有统计学意义（P〈0．05）。观察组恶性心律失常、恶心呕吐的发生率低于对照组，差异有统计学意义（P〈O．05）；术后TIMI3级血流比例及30d不良事件发生比例两组差异无统计学意义（尸〉O．05）。结论在急性下壁心肌梗死PCI术中出现低灌注时，应用参附注射液加压快速静脉滴注改善低灌注，较多巴胺能更缓和地达到纠正低血压的效果，减少不良反应发生。Objective To compare the effect of pressurized rapid intravenous drip of Shenfu and micro-pumping of dopamine on hypoperfusion in percutaneous coronary intervention （PCI） of acute inferior wall myocardial infarction. Methods A total of 80 patients with acute inferior wall myocardial infarction treated with emergency PCI in Chest Pain Unit of Yantaishan Hospital of Yantai City from May 2014 to May 2015 were enrolled. Then these patients were divided into observation group （n=40, pressurized rapid intravenous drip of normal saline and Shenfu） and control group （n=40, pressurized intravenous drip of normal saline with the same pressure combined with micro-pumping of Dopamine） according to random number table. Blood pressure and heart rate per five minutes were observed and recorded before intravenous drug, five to forty minutes after intravenous drug. Besides, the incidence rates of malignant arrhythmia, vomitting, TIMI grade three flows after intrqvenous drug and major adverse cardiovascular events after 30 days of a follow-up were also observed and recorded. Results Systolic pressure, diastolic pressure and mean arterial pressure of patients between two groups all met and maintained to the expectation after treatment with significant differences between two groups （P 〈 0.05）. The incidence rates of malignant arrhythmia, nausea and vomitting in observation group were lower than those in control group with significant differences （P〈0.05）. There was no statistically significant difference in the proportion of TIMI grade three flows and the incidence of major adverse cardiovascular events after 30 days of a follow-up （P 〉 0.05）. Conclusions When the hypoperfusion appears during PCI of acute inferior wall myocardial infarction, the pressurized rapid intravenous drip of Shenfu can improve hypoperfusion which is better than Dopamine in the effects of correcting hypotension and reducing the occurrence of adverse events.

关 键 词：多巴胺 参附注射液 心肌梗死 低灌注 PCI术 

分 类 号：R473.5[医药卫生—护理学]