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題 名 | 急性心肌梗塞病人的阿斯匹靈藥物使用=Administration of Aspirin in Patients with Acute Myocardial Infarction |
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作 者 | 李芳年; 胡勝川; 高偉峰; 羅鴻彰; 李建賢; | 書刊名 | 中華民國急救加護醫學會雜誌 |
卷 期 | 8:1 1997.03[民86.03] |
頁 次 | 頁13-17 |
分類號 | 415.3161、415.3161 |
關鍵詞 | 急性心肌梗塞; 標準照護流程; 阿斯匹靈; 高級心臟救命術; Acute myocardial infarction; Advanced cardiac life support; Aspirin; Standard care; |
語 文 | 英文(English) |
中文摘要 | 對急性心肌梗塞丙人緊急處理的標準照護流程,阿斯匹靈(Aspirin)為一必要藥物,此藥應儘早給予、且應被咬碎以提早發生效應。本前瞻性研究,探討對急性心肌梗塞病人處理之阿斯匹靈投予情況。自1995年12月到1996年5月,共有135位經由急診確定為急性心肌梗塞病人收入本研究,由症狀發生到診斷急性心肌梗塞之時間為946分鐘(範圍:30-8010分),135病人中有99位(73.3%)被給予阿斯匹靈,而此藥物之給予時間平均為到院後的69.7分鐘(範圍:1-810分)。在75位由他院轉入病人中僅有23位(30.7%)在原醫院服用阿斯匹靈,且只有5位病人(21.7%,5/23)將阿斯匹靈咬碎服用。在52位未服用阿斯匹靈的轉院病人中,有30位到本院後給予阿斯匹靈;而在非轉院病人中(60位)有46位服用阿斯匹靈,故於本院之阿斯匹靈給藥率為67.9%(30+46/52+60),且在此76位病人中,亦僅有33位(43.4%,33/76)將阿斯匹靈咬碎。由此顯示內科相關科系位院醫師對於急性心肌梗塞病人之緊急醫療處置訓練,關於阿斯匹靈之給予方面,醫學中心之訓練優於區域級下醫院(p<0.001);但對於阿斯匹靈之給藥方式:要囑咐病人要將此藥咬碎後再吞服、以及給藥時間方面、要儘早給藥,則尚未達到統計學上的明顯差異(p值分別為0.061及0.079)。由以上資料顯示:我國的內科相關科系住院醫師訓練尚有缺陷存在,對這些住院醫師加強急性心肌梗塞之緊急處理,例如:高級心臟救命術(ACLS)訓練是必要的。 |
英文摘要 | Aspirin is an essential drug in the early management of patients with an acute myocardial infarcition (AMI), independent of whether thrombolytic therapy is used.We conducted an observational study to evaluate the appropriateness of aspirin administration in the management of AMI patients. One hundred and thirty-five consecutive patients, admitted to the coronary care unit (CCu) via the emergency department(ED) diagnosed as having AMI,were enrolled in this study from December 1995 to May 1996.Patients demographics, cardiac history, symptoms, time of acute symptom onset, time of AMI diagnosis, administration of aspirin, and method and timing of dispensing were evaluated. Time time interval between symptom onset and AMI diagnosis was 946(range, 30-8010)minutes.Aspirin was given in 99(77.3%)of the patients.Seventy five patients were transferred from other hospitals, in whom, aspirin was started in 23(30.7%)patients by the initial hospital.The aspirin was chewed and then swallowed in only 5(21.7%)of the 23 patients.Aspirin was given to 30 of the 52 transferred patients who had not received it previously after arrival at our hospital.In the non-transferred patient group(n=60),aspirin was given to 46 patients.The overall aspirin prescription rate in our hospital was group(n=60),aspirin was given to 46 patients.The overall aspirin prescription rate in our hsopital was 67.9%,(30+46)/(52+60).Of these 76 patients. only 33(43.4)patients chewed the aspirin before swallowing. Immediate aspirin(160-325 mg)administration is recommended for patients with AMI.The aspirin should be chewed to allow for a more rapid onset of action. The present study indicates resident training defects and/or inadequate attending supervision in the immediate management of AMI patients.The principles of advanced cardiac life support(ACLS)training need to be adhered to improve AMI care among our patients. |
本系統中英文摘要資訊取自各篇刊載內容。