摘要
目的总结高龄急性心肌梗死 (AMI)的最佳治疗方案。方法收集我院 1995年 5月～ 2 0 0 3年 3月监护病房住院确诊为AMI的 110例 ,据年龄分为高龄组 (≥ 75岁 )和普通老年组 ( 60～ 74岁 ) ,观察患者的临床特征 ,不同的治疗方法 ,以及住院期间不良心血管事件发生率及转归情况。结果高龄组胸痛至治疗开始时间偏长 (P <0 0 5 ) ,血清肌酸激酶 (CK)高于对照组 (P <0 0 5 ) ,住院期间发生室颤 9例 ( 18% ) ,Ⅱ～Ⅲ度房室传导阻滞 6例 ( 12 % ) ,泵衰竭 16例 ( 3 2 % ) ,死亡 7例 ( 14 % ) ,均明显高于对照组 (P <0 0 5 ) ,溶栓治疗效果差 (P >0 0 5 )。结论高龄AMI患者并发症多 ,病死率高 ,是由复杂的因素造成的 ,在临床上如能因人而异选择合适的治疗方案 ,密切观察病情变化 ,及早发现并发症 ,积极恰当处理 。
Objective To summarize the primary treatment option for acute myocardial infarction(AMI) in the aged. Methods This study enrolled 110 cases of confirmed AMI hospitalized to ICU of the Hospital between May,1995 and March,2003.They were divided into two age groups according to their ages,very senior group including those over 75 years of age,and the general group aged from 60 to 74 years.Patients current status,treatments they received,unwanted cardiao-vascular events and their outcome were recorded and analyzed. Results The patients in the very senior group had a long delay between the onset of chest pain and the treatment(P<0.05);their serum CK concentration was higher than that of general group(P<0.05);ventricular fibrillation happened to 9 patients (18%);6 suffered from Ⅱ to Ⅲ degree of atrioventricular block (12%);pump failure ocurred in 16 patients (32%);7 patients died when hospitalized(14%).All these indexes were higher than those in the general group(P<0.05).Poor response was found to thrombolysis therapy(P>0.05). Conclusions Much more complications would result from AMI in the aged patients and would lead to high mortality rate.The causal factors were very complicated.Therefore,a individulized treatment should be selected in clinical practice;changes in patients' condition should be closely observed;proper management should be actively carried out so as to reduce the mortality.
出处
《临床误诊误治》
2004年第6期381-382,共2页
Clinical Misdiagnosis & Mistherapy
