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冠心病人自身携带的急救小药盒,主要用于防止和缓解冠心病心绞痛及心肌梗塞的急性发作.它由硝酸甘油、长效硝酸甘油、亚硝酸异戊酯吸入剂、潘生丁和安定组成。根据近年来应用抗心绞痛药物的临床实践,建议该急救盒中的药物组成应作适当调整,可撤除潘生丁、亚硝酸异戊酯吸入剂和长效硝酸甘油,换入消心痛、心得安和心痛定。 近年来的研究已证实潘生丁扩张冠状动脉的小阻力血管可引起“冠脉窃血”现象.它不能扩张静脉,故不能减轻心脏前负荷,亦不能增加心内膜下的血流量,对心绞痛急性发作时的症状和心电图改变均无影响。因此,它不适用于心绞痛的急性发作,也不能减少心绞痛的发作次数。亚硝酸异戊酯吸入剂虽然显效快,但因挥发性强而维持时间太短,又因峰浓度过高,致使病人即刻产生剧烈头痛、严重低血压和心动过速,且有异味刺鼻、使用不便和剂量不易掌握等缺点,在临床上已极少应用。长效硝酸甘油由于疗效不确切、久用有耐药性,现也趋于淘汰而罕用.
Coronary heart patients own first aid kit, mainly for the prevention and mitigation of acute attacks of angina pectoris and myocardial infarction.It is composed of nitroglycerin, long-acting nitroglycerin, isoamyl nitrite inhaler, dipyridamole and diazepam. According to the clinical practice of applying anti-anginal medicine in recent years, it is suggested that the composition of the medicine in the first-aid box should be adjusted appropriately, and dipyridamole, isoamyl nitrite inhaler and long-acting nitroglycerin can be withdrawn, and the anti-angina pectoris, set. In recent years, studies have confirmed that dipyridamole coronary artery expansion of small resistance vessels can cause “coronary steal” phenomenon.It can not expand the vein, it can not reduce the pre-cardiac load, also can not increase the subendocardial blood flow, acute angina Attack symptoms and ECG changes have no effect. Therefore, it does not apply to acute episodes of angina and does not reduce the number of episodes of angina. Although amyl nitrite inhalation effective, but because of strong volatile and maintenance time is too short, due to the peak concentration is too high, resulting in immediate severe acute headache, severe hypotension and tachycardia, and pungent odor, Inconvenient to use and dose not easy to grasp other shortcomings, has been rarely used in clinical practice. Long-acting nitroglycerin due to curative effect is not exact, long use of drug resistance, are also tend to be eliminated and rarely used.