摘要
目的分析探究急性心肌梗死的临床特征以及诊断治疗技巧。方法在2019年1月-2021年6月选择40例冠状动脉痉挛导致急性心肌梗死的患者展开回顾性分析,收集患者临床各项基础资料对其临床诊断经验等进行综合分析。结果对于因为冠状动脉痉挛所导致此类疾病的患者不论是接受血管内超声、经冠状动脉造影检查还是接受光学相干断层扫描等检查均以多元化的表现方式为主,以上40例患者中左前降支痉挛急性前壁心肌梗死,右冠状动脉痉挛急性下壁心肌梗死,右冠降支、左前降支、左回旋支痉挛急性下壁合并前壁心肌梗死的人数占比分别为6:28:6;患者在手术过程中接受经冠状动脉硝酸甘油治疗后其临床症状均全部消失,手术后给予其钙离子拮抗剂、硝酸酯类、他汀类药物综合治疗后其胸痛、胸闷等症状均得到极大程度的缓解;1例患者治疗无效并发心源性休克死亡。结论临床中对于冠状动脉痉挛导致急性心肌梗死的患者在临床诊断中可选择血管内超声等方式进行鉴别诊断,进而结合其各项检查结果为其制定针对性的药物治疗方案,经研究可见,为其提供钙离子拮抗剂联合硝酸酯类进行干预的治疗效果更为理想。
Objective To analyze the clinical characteristics,diagnosis and treatment of acute myocardial infarction.Methods From January 2019 to June 2021,40 patients with acute myocardial infarction caused by coronary artery spasm were selected for retrospective analysis,and their clinical basic data were collected for comprehensive analysis of their clinical diagnosis experience.Results The patients with such diseases caused by coronary artery spasm were mainly manifested in a variety of ways,whether they received intravascular ultrasound,coronary angiography or optical coherence tomography.Among the above 40 patients,the left anterior descending artery spasm acute anterior wall myocardial infarction,the right coronary artery spasm acute inferior wall myocardial infarction,the right descending coronary artery,the left anterior descending coronary artery The proportion of acute inferior wall of left circumflex branch spasm with anterior wall myocardial infarction was 6:28:6 respectively;All the clinical symptoms disappeared after the patients were treated with coronary artery nitroglycerin during the operation.After the operation,the chest pain,chest tightness and other symptoms were greatly relieved after the comprehensive treatment with calcium antagonists,nitrates and statins;One patient died of cardiogenic shock after ineffective treatment.Conclusion Intravascular ultrasound and other methods can be selected for the clinical diagnosis of patients with acute myocardial infarction caused by coronary artery spasm,and then a targeted drug treatment plan can be formulated for them in combination with their examination results.The study shows that it is more ideal to provide calcium antagonists combined with nitrates for the treatment of acute myocardial infarction.
作者
单阿丽
SHAN Ali(Dafeng People's Hospital,Yancheng,Jiangsu 224100)
出处
《智慧健康》
2022年第22期29-32,共4页
Smart Healthcare
关键词
急性心肌梗死
临床诊治
冠状动脉痉挛
Acute myocardial infarction
Clinical diagnosis and treatment
Coronary artery spasm
