摘要
目的分析急性ST段抬高型心肌梗死（STEMI）患者直接冠状动脉介入治疗（PCI）发生电风暴的危险因素，为预见性护理提供依据。方法总结2008年1月至2010年12月114例STEMI患者直接PCI的临床资料，将24h内自发室性心动过速（VT）或心室颤动（VF）≥2次，需紧急治疗者归入电风暴组，其余纳入对照组。结果电风暴发生9例，发生率7．9％。电风暴组患者入院时肌酸激酶同工酶（CK—MB）值（105．8±16．3）U／L、高于对照组（90．4±17．5）U／L，差异有统计学意义（t=2．545，P〈0．05）；肌钙蛋白I（TNI）值及梗死相关动脉（IRA）为右冠状动脉、TIMI0级血流、心动过缓、持续性低血压发生率均显著高于对照组，差异有统计学意义（P〈0．05）。结论CK—MB值、TNI值、IRA为右冠状动脉、无帆流、心动过缓、持续性低帆压是发生电风暴的主要危险因素，应在护理过程中重视这些高危风险，配合临床治疗，改善预后。
Objective To investigate the risk factors for occurrence of electrical storm in the patients with acute ST segment elevation myocardial infarction （STEMI） when giving treatment of percutaneous coronary intervention （PCI） and to provide evidence for prospective nursing. Methods Collected the clinical data of 114 patients with STEMI and treated by PCI from January 2008 to December 2010, patients with no less than twice spontaneous ventricular tachycardia （VT） or ventricular fibrillation （VF） were classified to the electrical storm group and others were classified to control group. Results The number of patients with electrical storm is nine and the incidence rate is 7.9%. The electrical storm group ：The value of ereatine kinase isoenzyme MB （CK-MB） in the electrical storm group was higher than in control group, （ 105.8 ± 16.3 ） U/L vs （ 90.4 ± 17.5 ） U/L, there was statistically significant difference（ t = 2. 545, P 〈 0. 05 ）. The value of troponin I （TNI）, right coronary artery being the infarction related artery （IRA） , TIMI 0 level blood flow, bradycardia and sustained hypotension in the electrical group are significantly higher than those of control group （P 〈 0. 05 ）. Conclusions The value of creatine kinase isoenzyme MB （CK-MB） , the value of troponin I （TNI）, fight coronary artery being the infarction related artery （IRA）, no blood flow, bradyeardia and sustained hypotension are the risk factors for occurrence of electrical storm which should be paid more attention in the process of nursing. The nursing should cooperate with clinical treatment to improve the prognosis.
出处
《中华现代护理杂志》
2011年第36期4446-4448,共3页
Chinese Journal of Modern Nursing
关键词
心肌梗死
冠状动脉介入治疗
电风暴
危险因素
护理
Myocardial infarction
Percutaneous coronary intervention
Electrical storm
Risk faetors
Nursing
