阵发性心房颤动患者的紧急医疗护理结果

O. Shtegman, D. I. Yarushina, A. E. Butylchenkova, V. K. Kozhukhova
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引用次数: 0

摘要

该研究的主要目的是评估心房颤动阵发性发作(房颤)院前阶段急救护理(EMC)的质量和效果。材料和方法:分析对象包括 111 名因房颤阵发性发作而呼叫救护车的患者。根据患者在救护小组在场的情况下恢复窦性心律的情况将其分为几组。在求医 30 天后对患者进行了电话调查。结果:40%的病例在医疗队在场的情况下恢复了窦性心律。同时,心律恢复时间的中位数为 32 分钟[Q1-Q3:29-50]。9% 的患者住院治疗。53%的患者拒绝住院治疗。在医疗小组的帮助下,心律恢复的概率增加,与抗心律失常药物的选择以及钾和镁药物的使用无关。与此同时,在接下来的 30 天内,心律恢复患者出现并发症(住院、房颤复发和反复呼叫救护车)的比例更高(43% 对 12%;P=0.00022)。在试图恢复心律的患者中,60.5%的患者没有使用抗凝药物,7%的患者同时使用了两种抗凝药物。结论在院前阶段提供 EMC 时,有 40% 的病例是在团队在场的情况下恢复心律的,这与未来 30 天内大量并发症以及与抗凝治疗相关的大量错误有关。
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The results of emergency medical care for patients with paroxysmal atrial fibrillation
The main purpose of the study was to assess the quality and effectiveness of emergency medical care (EMC)in atrial fibrillation paroxysm (AF) at the prehospital stage. Materials and methods: the analysis included 111 patients who called an ambulance due to AF paroxysm. The patients were divided into groups depending on the recovery of sinus rhythm in the presence of a team. A telephone survey of patients was conducted 30 days after seeking medical help. Results: the sinus rhythm in the presence of the brigade was restored in 40% of cases. At the same time, the median recovery time of the rhythm was 32 minutes [Q1–Q3: 29–50]. 9% of patients were hospitalized. 53% of patients refused hospitalization. The probability of rhythm recovery increased with the help of a medical team and was not associated with the choice of an antiarrhythmic and the use of potassium and magnesium drugs. At the same time, in the next 30 days, complications (hospitalization, recurrence of AF and repeated call an ambulance) were observed more often among patients with restored rhythm (43% vs. 12%;p=0.00022). In 60.5% of patients who were trying to restore the rhythm, No anticoagulants were used, and in 7% 2 anticoagulants were used simultaneously. Conclusion. When providing EMC at the prehospital stage, rhythm restoration in the presence of a team is observed in 40% of cases, which is associated with a large number of complications in the next 30 days and a large percentage of errors associated with anticoagulant therapy.
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