报告1例急性缺血性脑卒中患者在静脉溶栓过程中突发心肌梗死的院内紧急救护体会。针对患者发病时胸痛症状不典型、病情进展迅速、急需经皮冠状动脉介入治疗等问题,采取院内紧急救护方案,包括快速识别急性心肌梗死、有效缩短术前准备时间、院内紧急安全转运等。经过20 d的治疗及护理,患者病情稳定出院。出院后随访3个月,患者状况良好。
To report intrahospital emergency care of sudden myocardial infarction during intravenous thrombolysis in a patient with acute ischemic stroke. Hospital emergency care plan was adopted in order to solve the problems such as atypical chest pain symptoms,rapid progress and urgent need for percutaneous coronary intervention. The plan included rapid identification of myocardial infarction,effective shortening of preoperative preparation time,safe and fast intrahospital transport,and etc. After 20 days of treatment and care,the patient was discharged from hospital in a stable condition. He was in good condition during 3 months follow-up after discharge.
[1] 《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2019》概要[J]. 中国脑血管病杂志,2020,17(5):272-281.
Writing Group of Report on Stroke Prevention and Treatment in China. Brief report on stroke prevention and treatment in China,2019[J]. China J Cerebrovasc Dis,2020,17(5):272-281.
[2] 常红,赵洁,王晓娟,等. 急性缺血性脑卒中患者静脉溶栓后出血预警模型的构建[J]. 中华护理杂志,2019,54(11):1648-1652.
Chang H,Zhao J,Wang XJ,et al.Construction of an early warning model of hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke[J]. Chin J Nurs,2019,54(11):1648-1652.
[3] 陈白杨,孙欣,白涛,等. 急性脑梗死静脉溶栓后急性心肌梗死一例报告及文献复习[J]. 中华脑血管病杂志(电子版),2020,14(2):117-120.
Chen BY,Sun X,Bai T,et al.Myocardial infarction following intravenous thrombolysis for acute ischemic stroke:a case report and literature review[J]. Chin J Cerebrovasc Dis(Electronic Edition),2020,14(2):117-120.
[4] Sweta A,Sejal S,Prakash S,et al.Acute myocardial infarction following intravenous tissue plasminogen activator for acute ischemic stroke:an unknown danger[J]. Ann Indian Acad Neurol,2010,13(1):64-66.
[5] Tanaka K,Ohara T,Ishigami A,et al.Fatal multiple systemic emboli after intravenous thrombolysis for cardioembolic stroke[J]. J Stroke Cerebrovasc Dis,2014,23(2):395-397.
[6] Yang CJ,Chen PC,Lin CS,et al. Thrombolytic therapy-associated acute myocardial infarction in patients with acute ischemic stroke:a treatment dilemma[J]. Am J Emerg Med,2017,35(5):804.e1-804.e3.
[7] 郝云霞,李庆印. 急诊经皮冠状动脉介入治疗护理实践指南的构建[J]. 中华护理杂志,2019,54(1):36-41.
Hao YX,Li QY.Construction of nursing practice guideline for emergency percutaneous coronary intervention[J]. Chin J Nurs,2019,54(1):36-41.
[8] 刘丽娜,王旭东. 急性心肌梗死的急诊急救[J]. 中国临床医生杂志,2016,44(2):10-13.
Liu LN,Wang XD.Emergency first aid for acute myocardial infarction[J]. Chin J Clin,2016,44(2):10-13.
[9] 刘雪梅,于红静,顾玉琴,等. 急性心肌梗死患者经皮冠状动脉介入术后延续护理质量指标的构建[J]. 中华急危重症护理杂志,2020,1(1):69-74.
Liu XM,Yu HJ,Gu YQ,et al.Construction of continuous nursing quality indicators after percutaneous coronary intervention in patients with acute myocardial infarction[J]. Chin J Emerg Crit Care Nurs,2020,1(1):69-74.
[10] Jia L,Wang H,Gao Y,et al.High incidence of adverse events during intra-hospital transport of critically ill patients and new related risk factors:a prospective,multicenter study in China[J]. Crit Care,2016,20:12.
[11] Harish MM,Janarthanan S,Siddiqui SS,et al.Complications and benefits of intrahospital transport of adult intensive care unit patients[J]. Indian J Crit Care Med,2016,20(8):448-452.
[12] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志,2019,47(10):766-783.
Cardiology Committee of Chinese Medical Association,Editorial Board of Chinese Journal of Cardiology. Guideline for diagnosis and treatment of patients with ST-elevation myocardial infarction(2019)[J]. Chin J Cardiol,2019,47(10):766-783.