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A method for selecting patients with acute myocardial infarction and ST segment elevation after thrombolytic therapy to perform endovascular percutaneous coronary intervention (PCI)

机译:一种选择溶栓治疗后急性心肌梗死和ST段抬高的患者进行血管内经皮冠状动脉介入治疗(PCI)的方法

摘要

FIELD: medicine.SUBSTANCE: allocate clinical and laboratory and instrumental parameters in patients with acute myocardial infarction with a rise in the segment of St: preservation/absence of pain in the heart after thrombolytic therapy, ST segment on the ECG after 60-90 minutes after thrombolytic therapy, level of consciousness, necessity In artificial ventilation (AV), the degree of acute heart failure by Killip, the presence of heart rhythm disturbances, the presence of large bleeding, the level of creatinine. If the pain in the heart area is maintained, there is no decrease in the ST segment on the ECG by 50% or more from the baseline level after 60-90 minutes from the onset of thrombolytic therapy, absence of coma, no need for ventilation, absence of pulmonary edema (Killip 3), absence of cardiogenic shock (Killip 4), the absence of severe brady- and tachyarrhythmias, the absence of continuing large bleeding, the presence of any level of creatinine in the blood, decide to perform CCI in the shortest possible time. When the pain syndrome in the heart area is reduced, the ST segment falls on the ECG by 50% or more from the baseline level 60-90 minutes after the onset of thrombolytic therapy, absence of coma, no need for ventilation, absence of pulmonary edema (Killip 3), absence of cardiogenic shock (Killip 4), absence of pronounced brady- and tachyarrhythmias, absence of continuing large bleeding, creatinine level in the blood of not more than 200 mcmol/l make the decision to conduct an intervention within 3-24 hours after thrombolytic therapy. When coma, the need for mechanical ventilation, the pulmonary edema (Killip 3), cardiogenic shock (Killip 4), severe brady- and tachyarrhythmias, continued large bleeding, with a creatinine level in the blood of more than 200 mcmol/l if the pain syndrome in the region of the heart and reduction of the ST segment on the ECG by 50% or more from the baseline level after 60-90 minutes from the onset of thrombolytic therapy make a decision about conservative treatment of the patient.EFFECT: method allows you to determine the timing and the possibility of transferring each individual patient with acute coronary syndrome and ST segment elevation after thrombolytic therapy to perform CCI.3 ex
机译:领域:医学。研究对象:为急性心肌梗死患者分配临床,实验室和仪器参数,其中St段上升:溶栓治疗后心脏的保留/无疼痛,60-90分钟后心电图上ST段上升溶栓治疗后的意识水平,必要性在人工通气(AV)中,基利普治疗的急性心力衰竭程度,心律失常的存在,大出血的存在,肌酐的水平。如果维持心脏区域的疼痛,则从溶栓治疗开始60-90分钟后,心电图上的ST段不会比基线水平降低50%或更多,无昏迷,无需通气,没有肺水肿(Killip 3),没有心源性休克(Killip 4),没有严重的心律失常和快速性心律失常,没有持续的大量出血,血液中存在任何水平的肌酐,决定进行CCI在最短的时间内。当心脏区域的疼痛综合征减轻时,溶栓治疗开始后60-90分钟,ST段在心电图上比基线水平下降50%或更多,无昏迷,无需通气,无肺水肿(Killip 3),无心源性休克(Killip 4),无明显的心律失常和快速性心律失常,无持续大量出血,血液中肌酐水平不超过200 mcmol / l,因此决定在以下范围内进行干预溶栓治疗后3-24小时。昏迷时需要机械通气,肺水肿(Killip 3),心源性休克(Killip 4),严重的心律失常和快速性心律失常,持续大量出血,如果血中肌酐水平超过200 mcmol / l,溶栓治疗开始后60-90分钟后,心脏区域疼痛综合征和ECG的ST段减少至基线水平的50%或更多,这决定了患者的保守治疗。可让您确定溶栓治疗后进行CCI.3 ex的每位急性冠脉综合征和ST段抬高患者的转移时间和可能性。

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