自动体外除颤在急性心肌梗死经皮冠状动脉介入治疗围手术期的临床应用  

Clinical application of automated external defibrillation in patients with acute myocardial infarction during the perioperative period of percutaneous coronary intervention

作　　者：陈康伟 黄文香 聂亮[1] 彭小及 欧阳鑫 CHEN Kangwei;HUANG Wenxiang;NIE Liang;PENG Xiaoji;OUYANG Xin(Interventional Therapy Center,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou341000,China;Outpatient Blood Collection Room,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]赣南医学院第一附属医院介入治疗中心,江西赣州341000 [2]赣南医学院第一附属医院门诊采血室,江西赣州341000

出　　处：《中国当代医药》2023年第19期53-56,共4页China Modern Medicine

基　　金：江西省赣州市卫生健康委员会市级科研计划项目(2022-2-91)。

摘　　要：目的探讨自动体外除颤在急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)治疗围手术期的应用价值。方法选取2019年3月至2022年8月赣南医学院第一附属医院收治的70例AMI患者作为研究对象,按照随机数字表法分为研究组(n=35)与对照组(n=35)。两组患者在采取PCI治疗围手术期间,发生恶性心律失常事件时均予除颤治疗,对照组采取手动除颤模式,研究组采取自动体外除颤模式。比较两组的急救情况(心室颤动识别用时、心搏骤停恢复用时、平均除颤次数、首次除颤成功率、院内生存率)及并发症(心力衰竭、心律失常、皮肤灼伤、诱发出血、休克)发生率,并比较两组患者干预前后的左心室射血分数(LVEF)。结果研究组患者心室颤动识别用时、心搏骤停恢复用时短于对照组,平均除颤次数少于对照组,首次除颤成功率(82.86%)高于对照组(60.00%),差异有统计学意义(P<0.05);两组的院内生存率比较,差异无统计学意义(P>0.05);研究组的并发症总发生率(2.86%)低于对照组(22.86%),差异有统计学意义(P<0.05);干预后,两组患者的LVEF均高于本组干预前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论AMI患者PCI围手术期应用自动体外除颤模式心室颤动识别与心搏骤停恢复用时少,除颤成功率高,生存率良好,有助于改善患者心功能,降低并发症发生风险,具有安全性。Objective To investigate the application value of automated external defibrillation in patients with acute myocardial infarction(AMI)during the perioperative period of percutaneous coronary intervention(PCI).Methods A total of 70 AMI patients admitted to the First Affiliated Hospital of Gannan Medical University from March 2019 to August 2022 were selected as the research objects,and they were divided into study group(n=35)and control group(n=35)according to the random number table method.During the perioperative period of PCI treatment,both groups were treated with defibrillation when malignant arrhythmia events occurred.The control group was treated with manual defibrillation mode,and the study group was treated with automatic external defibrillation mode.The emergency situation(identification time of ventricular fibrillation,recovery time of cardiac arrest,average number of defibrillation,success rate of first defibrillation,in-hospital survival rate)and the incidence of complications(heart failure,arrhythmia,skin burns,induced bleeding,shock)were compared between the two groups.The left ventricular ejection fraction(LVEF)of the two groups before and after intervention were compared.Results The identification time of ventricular fibrillation and recovery time of cardiac arrest in the study group were shorter than those in the control group,the average number of defibrillation was less than that in the control group,and the success rate of first defibrillation(82.86%)was higher than that in the control group(60.00%),and the differences were statistically significant(P<0.05).There was no significant difference in the in-hospital survival rate between the two groups(P>0.05).The total incidence of complications in the study group(2.86%)was lower than that in the control group(22.86%),and the difference was statistically significant(P<0.05).After intervention,the LVEF of the two groups were higher than those before intervention,and the LVEF of the study group was higher than that of the control group,and the differ

关 键 词：自动体外除颤模式 急性心肌梗死 经皮冠状动脉介入治疗 急救情况 并发症 左室射血分数 

分 类 号：R542.22[医药卫生—心血管疾病]