1022例陈旧性心肌梗塞患者监护拔牙的临床分析

目的 总结陈旧性心肌梗塞(OMI)患者在监护拔牙过程中并发症的变化及处理。方法 1022例陈旧性心梗患者拔牙的全过程，均在心电图、血压和临床表现的监护下进行。术前、术中根据心率、血压等情况给予相关的用药，记录术前、麻醉中、术中和术后的观察结果。结果 1015例完成手术，其中283例术中出现需要处置的心肌缺血或缺血加重、血压升高及心率失常等改变，7例因并发症停止拔牙治疗。结论 在术前对症用药、严密监护条件下，可安全地完成OMI患者的牙拔除治疗。

A study on the teeth extraction in 1022 patients with old myocardial infarction

Objective Applicability of electrocardiographic monitoring was studied in the teeth extraction of patients with old myocardial infarction. Methods One thousand and twenty - two cases with old myocardial infarction who needed teeth extraction under cardio - monitor entered the study. Clinical manifestations, blood pressure and electrocardiogram were monitored for each patient during the operation. Results One thousand and fifteen patients underwent extraction of teeth, among them seventy - seven patients had deteriorating myocardial ischemia, fifty - two patients had high had blood pressure increase to at/or over 200/120mmHg, and one hundred and fifty- four patients had arrhythmia during surgery; which were discovered at early stage and were controlled with proper medication, and with oxygen supply, thesurgery was finished. Only seven patients were quitted because of suffered severe complication. Conclusion Old myocardial infarction is not a contraindication in extracting teeth. But it should be selected appropriately, monitored closely with adequate preparation of preventive medication.