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目的探讨急性心肌梗死后心脏性猝死(SCD)预防的关键环节。方法回顾56例急性心肌梗死后心脏性猝死患者的病历及随访资料,分析其原因或诱因、发病季节与发病时间、溶栓治疗与SCD的关系、致命性心律失常与SCD的相关性与预后等。结果严重心律失常为SCD的主要诱因,冬秋季多于春夏季,白天多于晚上,上午多于下午;住院治疗1周后、出院1周后为SCD的高发期,血钾偏低者多见,前壁多于下壁,未溶栓及溶栓未再通者SCD死亡率高。结论综合分析患者病例资料,密切观察病情变化,加强对关键环节的管理,对降低急性心肌梗死后心脏性猝死的发生具有积极的意义。
Objective To explore the key points of prevention of sudden cardiac death (SCD) after acute myocardial infarction. Methods The clinical data and follow-up data of 56 patients with sudden cardiac death after acute myocardial infarction were retrospectively analyzed, and the causes or inducing factors, the season and time of onset, the relationship between thrombolytic therapy and SCD, the correlation and prognosis of lethal arrhythmia and SCD . Results Serious arrhythmia was the main cause of SCD, more in winter and autumn than in spring and summer, more in the daytime than in the evening and more in the morning than in the afternoon. One week after hospitalization, one week after discharge was the high incidence of SCD, , The anterior wall more than the inferior wall, no thrombolysis and thrombolysis no recovery of SCD high mortality. Conclusion The comprehensive analysis of patient data, close observation of disease changes, and strengthening the management of key links have a positive effect on reducing the incidence of sudden cardiac death after acute myocardial infarction.