心肌梗塞发作后宜早做手术
http://www.100md.com
2001年1月10日
NEW YORK (Reuters Health) - Emergency surgery may save the lives of more patients who go into shock after suffering a heart attack, results of a new study suggest.
Researchers say the findings--from a multicenter 5-year trial--show that immediate surgery to restore blood flow to the heart boosts the long-term survival odds of patients who go into cardiogenic shock.
Cardiogenic shock sets in when the heart fails to pump enough blood to other organs. According to the American Heart Association (news - web sites), between 5% and 15% of heart attack patients who get to the hospital develop cardiogenic shock. About two thirds of these patients die.
Since quick action may cut this death rate, getting to the hospital at the first signs of a heart attack is crucial, the study's lead researcher said.
The current study suggests that promptly performing artery-clearing angioplasty or heart bypass surgery increases the likelihood of patients surviving the year after their heart attacks.
The researchers advise that heart attack patients suffering cardiogenic shock be quickly transferred to a hospital with the capability to perform urgent heart imaging studies and procedures to reopen a blocked vessel.
Of 300 patients in cardiogenic shock, those who had emergency surgery were 39% more likely to be alive one year later compared with those who received less-aggressive treatment, the study authors found. The benefit was, however, confined to patients younger than 75. The findings are published in the January 10th issue of The Journal of the American Medical Association (news - web sites).
Lead study author Dr. Judith S. Hochman of St. Luke's-Roosevelt Hospital Center in New York City told Reuters Health that these results ``reinforce and amplify'' the benefits of early surgery for cardiogenic shock.
Already, the American College of Cardiology and American Heart Association have revised their guidelines for treating cardiogenic shock based on earlier findings from this trial. Last year, Hochman's team reported that early surgery cut patients' death risk over 6 months.
``This study,'' Hochman said, ``shows the findings for 6 months wasn't just a fluke.''
Early warning signs of a heart attack include pain or pressure in the chest that may extend to the shoulder and arm, lightheadedness, nausea and breathlessness.
SOURCE: The Journal of the American Medical Association 2001;285:190-192., 百拇医药
Researchers say the findings--from a multicenter 5-year trial--show that immediate surgery to restore blood flow to the heart boosts the long-term survival odds of patients who go into cardiogenic shock.
Cardiogenic shock sets in when the heart fails to pump enough blood to other organs. According to the American Heart Association (news - web sites), between 5% and 15% of heart attack patients who get to the hospital develop cardiogenic shock. About two thirds of these patients die.
Since quick action may cut this death rate, getting to the hospital at the first signs of a heart attack is crucial, the study's lead researcher said.
The current study suggests that promptly performing artery-clearing angioplasty or heart bypass surgery increases the likelihood of patients surviving the year after their heart attacks.
The researchers advise that heart attack patients suffering cardiogenic shock be quickly transferred to a hospital with the capability to perform urgent heart imaging studies and procedures to reopen a blocked vessel.
Of 300 patients in cardiogenic shock, those who had emergency surgery were 39% more likely to be alive one year later compared with those who received less-aggressive treatment, the study authors found. The benefit was, however, confined to patients younger than 75. The findings are published in the January 10th issue of The Journal of the American Medical Association (news - web sites).
Lead study author Dr. Judith S. Hochman of St. Luke's-Roosevelt Hospital Center in New York City told Reuters Health that these results ``reinforce and amplify'' the benefits of early surgery for cardiogenic shock.
Already, the American College of Cardiology and American Heart Association have revised their guidelines for treating cardiogenic shock based on earlier findings from this trial. Last year, Hochman's team reported that early surgery cut patients' death risk over 6 months.
``This study,'' Hochman said, ``shows the findings for 6 months wasn't just a fluke.''
Early warning signs of a heart attack include pain or pressure in the chest that may extend to the shoulder and arm, lightheadedness, nausea and breathlessness.
SOURCE: The Journal of the American Medical Association 2001;285:190-192., 百拇医药