论文部分内容阅读
急性心肌梗塞(AMI)性心源性休克的发生是由于急性或累积性大面积的心肌损伤超过40%的结果,其发生率在 AMI 住院病人中占10～15%,AMI 发生后3小时内受到积极处理者仅4%病人出现心源性休克(CS),若处理晚于3小时则有13%出现 CS。因心肌广泛性损伤病死率高达80%以上。治疗难度也大。临床上应与传统的心源性休克相鉴别因二者预后不同。AMI 并 CS 诊断标准:1.AMI 原来血压正常者收缩压下降到80毫米汞柱或以下;原来血压高者收缩压下降达80毫米汞柱。2.出现休克的临床表现如尿少、四肢末稍循环不良,冷汗及不安等。3.血流动力学指标:心脏指数小于1.8升/分/米~2。肺动脉楔嵌压大于18毫米汞柱。
Acute myocardial infarction (AMI) Cardiogenic shock occurs as a result of more than 40% of acute or cumulative large areas of myocardial injury, occurring in 10-15% of AMI inpatients and within 3 hours of AMI Cardiac shock (CS) occurred in only 4% of patients who were actively treated, and 13% of patients presented CS after 3 hours of treatment. Due to extensive myocardial injury fatality rate as high as 80%. Treatment is also difficult. Clinic should be differentiated from the traditional cardiogenic shock due to the different prognosis. AMI and CS diagnostic criteria: 1. AMI normotensive normal systolic blood pressure dropped to 80 mm Hg or less; the original high blood pressure systolic blood pressure dropped to 80 mm Hg. 2. Shock clinical manifestations such as oliguria, limbs, poor circulation, cold sweat and anxiety. 3. Hemodynamic indicators: cardiac index less than 1.8 liters / min / m ~ 2. Pulmonary artery wedge pressure greater than 18 mm Hg.