允许性低血压在需机械辅助通气的急性心肌梗死患者中的治疗分析  

Analysis of the Treatment of Permissive Hypotension in Patients with Acute Myocardial Infarction Requiring Mechanical Ventilation

作　　者：刘东华 齐姗姗 马波 杨磊 于海涛 LIU Donghua;QI Shanshan;MA Bo;YANG Lei;YU Haitao(Second Community Health Service Center,Wenhua Street,Jianhua District,Qiqihar,Heilongjiang Province,161000 China;Department of Intensive Medicine,Third Affiliated Hospital of Qiqihar Medical College,Qiqihar,Heilongjiang Province,161000 China;Third Affiliated Hospital of Qiqihar Medical College,Qiqihar,Heilongjiang Province,161000 China)

机构地区：[1]齐齐哈尔市建华区文化街道第二社区卫生服务中心,黑龙江齐齐哈尔161000 [2]齐齐哈尔医学院附属第三医院重症医学科,黑龙江齐齐哈尔161000 [3]齐齐哈尔医学院附属第三医院,黑龙江齐齐哈尔161000

出　　处：《中外医疗》2021年第11期11-14,共4页China & Foreign Medical Treatment

基　　金：齐齐哈尔医学科学院面上基金项目(QMSI2019M-29)。

摘　　要：目的探讨需机械辅助通气的急性心肌梗死患者实施允许性低血压治疗的临床价值。方法回顾性随机对照研究,纳入该院收治的2018年7月—2019年7月需机械辅助通气的急性心肌梗死患者88例为研究对象,随机分为对照组和观察组。44例应用允许性低血压策略者为观察组,44例维持正常血压者为对照组。分析两组患者抢救成功率、病死率、平均机械通气时间、平均ICU入住时间、平均住院时间、心血管不良事件(心力衰竭、心绞痛、肾功能衰竭、再次梗死)发生概率。结果治疗后,观察组抢救成功率97.73%,明显高于对照组;观察组病死率2.27%,明显低于对照组,差异有统计学意义(χ^(2)=3.880,P=0.049);观察组平均机械通气时间(8.15±1.05)d,平均ICU入住时间(9.28±1.23)d,平均住院时间(16.54±2.17)d,均明显短于对照组,差异有统计学意义(t=13.530、15.694、10.161,P<0.001);治疗后,观察组心血管不良事件(心力衰竭、心绞痛、肾功能衰竭、再次梗死)发生概率9.30%,与对照组相比差异无统计学意义(χ^(2)=0.304,P=0.582)。结论需机械辅助通气的急性心肌梗死患者实施允许性低血压治疗的临床价值显著,可减少病死率,缩短其平均机械通气时间、平均ICU入住时间及住院时间,不增加心梗复发率、肾功能衰竭等不良事件,提高治愈率。Objective To explore the clinical value of permissive hypotension treatment in patients with acute myocardial infarction who require mechanical ventilation.Methods A retrospective randomized controlled study included 88 patients with acute myocardial infarction requiring mechanical ventilation in the hospital as the research objects from July 2018 to July 2019,and were randomly divided into control group and observation group.44 patients who applied the permissive hypotension strategy were the observation group,and 44 patients who maintained normal blood pressure were the control group.Analysed of the rescue success rate,fatality rate,average mechanical ventilation time,average ICU stay,average hospital stay,and probability of adverse cardiovascular events(heart failure,angina pectoris,renal failure,re-infarction)of the two groups of patients was analyzed.Results After treatment,the rescue success rate of the observation group was 97.73%,which was significantly higher than that of the control group;the mortality rate of the observation group was 2.27%,which was significantly lower than that of the control group,the difference was statistically significant(χ^(2)=3.880,P=0.049);the average mechanical ventilation time of the observation group was(8.15±1.05)d,the average ICU stay time was(9.28±1.23)d,and the average hospital stay was(16.54±2.17)d,which were significantly shorter than those of the control group,the difference were statistically significant(t=13.530,15.694,10.161,P<0.001).After treatment,the incidence of adverse cardiovascular events(heart failure,angina pectoris,renal failure,re-infarction)in the observation group was 9.30%,which was not statistically significant compared with the control group(χ^(2)=0.304,P=0.582).Conclusion The clinical value of permissive hypotension treatment in patients with acute myocardial infarction requiring mechanical ventilation is significant,which can reduce the mortality rate,shorten their average mechanical ventilation time,average ICU stay time and hospital stay,a

关 键 词：急性心肌梗死 机械辅助通气 允许性低血压 临床疗效 心血管不良事件 

分 类 号：R542.2[医药卫生—心血管疾病]