早期尿激酶静脉溶栓治疗急性心肌梗死循证护理.docVIP

早期尿激酶静脉溶栓治疗急性心肌梗死循证护理[摘要] 目的 探讨循证护理在急性心肌梗死（AMI）早期尿激酶溶栓治疗中的应用效果。 方法 选择29例AMI患者，均为采用尿激酶溶栓治疗，并采用循证护理方法进行护理。 结果 29例患者均好转出院，其中21例溶栓成功，再通率达72.41%，24例患者的胸痛迅速消失或缓解；发生再灌注心律失常26例，2例患者皮肤出现静脉穿刺部位瘀斑，未见牙龈出血、消化道出血及出血性脑卒中等并发症。结论 在AMI溶栓治疗中应用循证护理方法，可有效地提高AMI患者的治愈率，降低并发症的发生率，提高患者的生活质量。 [关键词] 急性心肌梗死；溶栓治疗；尿激酶；循证护理 [中图分类号] R473.5 [文献标识码] B [文章编号] 1674-4721（2012）07（a）-0150-03 Evidence-based nursing of the early intravenous thrombolytic with urokinase treatment for acute myocardial infarction HE Aiping Jingzhou Hospital, Tongji Medical College of Huazhong University of Science Technology in Hubei Province, Jingzhou 434020, China [Abstract] Objective To discuss the apply effect of the evidence-based nursing of the early intravenous thrombolytic with urokinase treatment for acute myocardial infarction. Methods Twenty nine patients with the AMI were chosen, and who were treated by the intravenous thrombolytic with urokinase, and then gave the evidence-based nursing for them. Results Twenty nine patients were all right and had left hospital, and 21 cases were thrombolysis successfully, the recanalization rate was 72.41%，the chest pain disappeared or relieved in 24 patients, 26 patients were happening to the reperfusion arrhythmia, 2 patients had the petechia with the skin when be punctured. No patient had the bleeding gums, gastrointestinal blooding or hemorrhagic apoplexy. Conclusion Using the evidence-based nursing in the acute myocardial infarction, and which is treated by early intravenous thrombolytic with urokinase, it can improve the cure rate of the acute myocardial infarction, low the complication, improve the patient’s quality of life. [Key words] Acute myocardial infarction; Thrombolytic therapy; Urokinase; Evidence-based nursing 急性心肌梗死（AMI）是临床上较严重的一种冠心病，是由于冠状动脉的突然闭塞、供血量不足或中断而导致相应心肌持久而严重的缺血导致心肌坏死，治疗的根本在于早期恢复已经闭塞的冠状动脉血流[1]。目前对AMI治疗最有效的措施是静脉溶栓治疗，大剂量尿激酶可使新鲜血栓溶解，尿激酶是当今国内应用比较广泛的溶栓剂，溶栓治疗的疗效具有时间的依赖性，也就是说发病时间与溶栓开始治疗的时间越短越好，因为这样情况下的梗死相关血管越易再通，但观察和护理工作也十分重要，治疗中护士起着不可替代的作用[2]。