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目的探讨急性心肌梗死合并心律失常的诊治方法。方法回顾性分析本院62例急性心肌梗死患者入院后随机分为早期组13例,中期组45例,晚期组4例。观察患者心律失常发生的时间、类型、诊断治疗情况及转归进行。结果急性心肌梗死患者以6~72 h心律失常的发生率最高,平均发生时间(66.7±19.5)h,中期组明显高于早期组和晚期组(P<0.05)。早期组心律失常以窦性心律过缓为主,中期组以室性早搏为主,晚期组以房性与交界性早搏为主,差异有统计学意义(P<0.05)。本组患者经及时诊断后治疗总有效率88.7%,1例患者因心功能不全猝死,病死率为1.6%。结论掌握急性心肌梗死并发心律失常的时间和类型,有助于进行针对性检查和观察,及时发现并治疗可提高预后,降低病死率。
Objective To investigate the diagnosis and treatment of acute myocardial infarction complicated with arrhythmia. Methods A retrospective analysis of 62 patients with acute myocardial infarction in our hospital after admission were randomly divided into early group of 13 cases, 45 cases of intermediate group, 4 cases of advanced group. Observe the time, type, diagnosis and treatment of patients with arrhythmia and outcome. Results The incidence of arrhythmia in patients with acute myocardial infarction was the highest at 6 ~ 72 h (mean ± SD) (66.7 ± 19.5 h), significantly higher than those in early and late stages (P <0.05). In the early group, the arrhythmia was mainly sinus rhythm. The interim group was mainly premature ventricular contractions, while the latter group was mainly atrial and borderline premature beat. The difference was statistically significant (P <0.05). This group of patients after timely diagnosis of the total effective rate of 88.7%, 1 patient died of cardiac insufficiency, the case fatality rate was 1.6%. Conclusions Mastering the timing and type of arrhythmia in patients with acute myocardial infarction is helpful for the targeted examination and observation. The timely detection and treatment can improve the prognosis and reduce the mortality.