急性心肌梗死PCI术患者并发心律失常的影响因素分析及护理对策  

Analysis the influencing factors of arrhythmia in patients with acute myocardial infarction undergoing PCI surgery and nursing countermeasures

作　　者：张艳红[1] 邵丽香[1] 郑晓丹[1] 伦爱美[1] 李婉凤 ZHANG Yan-hong;SHAO Li-xiang;ZHENG Xiao-dan;LUN Ai-mei;LI Wan-feng

机构地区：[1]肇庆市第一人民医院心血管内科,肇庆市526000

出　　处：《护理实践与研究》2020年第6期1-4,共4页Nursing Practice and Research

摘　　要：目的探讨急性心肌梗死PCI术患者心律失常发生的相关因素,为制订前瞻性护理防范措施提供依据。方法选取2017年1-12月本院住院的急性ST段抬高型心肌梗死急诊PCI术患者120例为研究对象,记录并分析心律失常发生的时间段、开通梗死血管时间、心肌梗死范围、罪犯血管位置、单支或多支血管病变等因素对并发心律失常的影响,分析心律失常的发生与梗死相关动脉的关系,并针对影响因素采取相应护理策略。结果120例患者中出现心律失常者55例,心律失常发生率为45.83%,以术中发生为最多见,其次为术后6 h内发生,较少发生在术后7~72 h。单因素分析显示急性心肌梗死后再灌注时间<6 h内、梗死范围、局限性梗死、罪犯血管(RCA)血管病变均是PCI术患者发生心律失常的相关因素(P<0.05)。结论缺血心肌恢复血流灌注发生的心律失常是急性心肌梗死急诊PCI治疗的紧急突发事件,也是冠脉再通的指标,因此要重视对心律失常的早期预测和防治,掌握其特点及影响因素,及时发现心律失常迅速采取针对性的处理措施,以提高冠状动脉介入治疗的成功率,减少心脏不良事件发生。Objective To explore the related factors of arrhythmia in patients with acute myocardial infarction undergoing PCI surgery and provide a basis for the development of prospective nursing precautions.Methods We select 120 cases of patients with acute ST-elevation myocardial infarction who were admitted to our hospital from January to December 2017 as the study subjects.The time period of arrhythmia,the time to open the infarcted vessels,the scope of myocardial infarction,the influence of factors such as the position of the right culprit artery,single or multiple vascular disease on concurrent arrhythmia were recorded and analyzed,and the relationship between the occurrence of arrhythmia and infarct-related arteries also were analyzed,and corresponding nursing strategies for the influencing factors were adopted.Results The 55 cases of arrhythmia occurred in 120 cases of patients,the incidence of arrhythmia was 45.83%,which was most common during the operation,secondly followed in 6 hours after operation,and less in 7-72 hours after operation.Univariate analysis showed that the reperfusion time<6 h after acute myocardial infarction,range of infarction,localized infarction,and vascular disease of the right culprit artery(RCA)were all related factors for arrhythmia in patients with PCI(P<0.05).Conclusion Arrhythmia due to ischemic myocardial recovery and blood flow perfusion was an emergency in the PCI treatment of acute myocardial infarction and was an indicator of coronary recanalization.Therefore,we must pay attention to the early prediction and prevention of arrhythmia,and master its characteristics and influencing factors,timely detection of arrhythmia and timely targeted measures to improve the success rate of coronary intervention treatment and reduce occurrence of cardiac adverse events.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 心律失常 护理对策 

分 类 号：R473.5[医药卫生—护理学]