心肺复苏联合急诊PCI抢救急性心肌梗死后心脏骤停的效果  

Effect of cardiopulmonary resuscitation combined with emergency PCI in rescue the patients of cardiac arrest after acute myocardial infarction

作　　者：黄艳[1] 戴朝晖[1] 石凤姣[1] 蒋志明[1] 黄方舟 Huang Yan;Dai Zhaohui;Shi Fengjiao;Jiang Zhiming;Huang Fangzhou(Department of emergency,The fourth hospital of Changsha,Changsha,China)

机构地区：[1]长沙市第四医院急诊急救中心

出　　处：《实用休克杂志（中英文）》2019年第6期340-342,346,共4页Journal of Practical Shock

基　　金：长沙市科技局科技计划项目(项目编号:K15ZD032-33)

摘　　要：目的探讨心肺复苏联合急诊PCI抢救急性心肌梗死后心脏骤停的效果。方法选取2013年5月至2019年5月我院所收治的急性心梗后心跳骤停患者81例,根据是否行急诊PCI,将其分为PCI组及对照组,PCI组在心肺复苏后行急诊PCI治疗,对照组在心肺复苏后行药物保守治疗。比较两组患者的治疗前后抢救成功率、不良事件发生率、心梗再发率、心绞痛复发率、再入院率,并对比两组存活患者治疗前后左室射血分数变化。结果PCI组抢救成功率明显高于对照组,心源性休克发生率、心梗复发率、心绞痛再发率及再入院率均明显要低于对照组,两组患者心力衰竭、严重出血发生率差异无统计学意义,两组患者经治疗后左室射血分数均较改善,但PCI组明显优于对照组。结论心肺复苏联合急诊PCI在抢救急性心肌梗死后心跳骤停患者中具有较好疗效,能够提高抢救成功率,减少不良事件的发生情况,促进患者心功能恢复。Objective To explore the effect of cardiopulmonary resuscitation(CPR)combined with emergency percutaneous coronary intervention(PCI)in rescue the patients of cardiac arrest after acute myocardial infarction(AMI).Methods We studied 81 patients with cardiac arrest after AMI who were treated in the forth hospital of Changsha during May 2013 to May 2019.They were divided into two groups according to whether they received emergency PCI.PCI group received emergency PCI after CPR,control group received medical treatment without emergency PCI after CPR.The survival rate,incidence of adverse events,recurrence rate of myocardial infarction,recurrence rate of angina pectoris were compared between the two groups,in addition,the variation of left ventricular ejection fraction before and after treatment were compared between the survivor in two groups.Results The survival rate in PCI group was significantly higher than control group,the incidence of cardiogenic shock,the recurrence rate of myocardial infarction,the recurrence rate of angina pectoris and the readmission rate were significantly lower than those in control group;there was no significant difference in the incidence of heart failure and severe bleeding between the two groups;the left ventricular ejection fraction of the two groups was improved after treatment,but PCI group was significantly better than the control group.Conclusions Cardiopulmonary resuscitation combined with PCI is effective in the treatment of cardiac arrest after acute myocardial infarction,it can improve the survival rate,reduce the incidence of adverse events and improve the heart function.

关 键 词：急诊PCI 急性心肌梗死 心脏骤停 

分 类 号：R542.22[医药卫生—心血管疾病] R541.78[医药卫生—内科学]