心区交感神经阻滞治疗急性心肌梗死泵衰竭

目的 评价心区交感神经阻滞（CSNB）治疗急性心肌梗死（AMI）泵衰竭疗效.方法AMI泵衰竭患者43例,随机分为治疗组22例,对照组21例.治疗组除行CSNB及手术当天停用抗血小板、抗凝药物外,其他药物处置与对照组相同.观察治疗后生命体征变化、心力衰竭症状、体征缓解及心脏功能改善情况.结果治疗30 min后,两组呼吸频率、收缩压下降（P＜0.05）;治疗组心率降低（P＜0.05）,对照组无显著变化（P＞0.05）.治疗15 min、30 min、60 min后,治疗组分别有12例、17例、21例心力衰竭症状与体征缓解、对照组对应分别为2例、8例、18例,两组比较差异有显著性（P＜0.01）.治疗24 h后,治疗组总有效率高于对照组（96%VS.62%,P＜0.05）.结论CSNB治疗AMI泵衰竭,起效快、疗效佳.

Effect of cardiac sympathetic nerve blockade on acute myocardial infarction associated with pump failure

Objective To evaluate the effect of cardiac sympathetic nerve blockade (CSNB) on acute myocardial infarction (AMI) associated with pump failure. Methods Forty-three patients with AMI and pump failure were randomly divided into two groups: treatment group (n=22) and control group (n=21). CSNB was administered to patients in treatment group, with the operation day the other treatment was the same as that in control group without anticoagulation drugs. After treatment, the change of vital signs, the improvement of clinical symptom or signs and cardiac function were observed.Results Thirty minutes after treatment, breathing rate and systolic blood pressure were decreased in the two groups (P<0.05).Heart rate decreased in treatment group (P<0.05), but didn't change in the control group (P>0.05). Fifteen minutes, 30 minutes and 60 minutes after treatment, 12 patients, 17 patients and 21 patients in the treatment group,respectively,showed improvement of clinical symptom or signs, with only 2, 8 and 18 in the control group. The difference was signficant (P<0.01). Twenty-four hours after treatment, the total effective ratio was higher in treatment group than that in the control group (96% VS.62%, P<0.05). Conclusion CSNB is quick and effective in treatment of AMI accompanied with pump failure.