急性心肌梗死合并胸腔积液60例分析

目的通过分析急性心肌梗死（AMI）合并胸腔积液的临床特点、治疗方法和预后，探讨急性心肌梗死合并胸腔积液的一般规律。方法分析急性心肌梗死患者130例的临床资料，选择60例急性心肌梗死合并胸腔积液患者，70例无胸腔积液的急性心肌梗死为对照，分析两种患者的临床特点、冠状动脉病变情况，以及治疗方法和预后等。结果急性前壁心肌梗死容易合并胸腔积液，与梗死面积有关，肌钙蛋白水平越高，发生胸腔积液的概率越大，利尿剂应用延迟也易发生胸腔积液。及时行胸腔引流、应用无创呼吸机及输注白蛋白可有效缓解呼吸困难，缩短住院时间，降低死亡率。结论急性心肌梗死合并中到大量胸腔积液并不少见，发病机制可能与梗死面积较大、利尿剂使用延迟等有关，及时发现并有效处理，可改善预后。

60 cases analysis of acute myocardial infarction with pleural effusion

Objective To discuss the general law o（ the patients with acute myocardial infarction complicated with pleural effusion through analyzing the clinical features, treatment and prognosis of the patients. Methods 130 cases of acute myocardial infarction were analyzed, including 60 cases of acute myocardial infarction complicated with pleura] effusion. The other 70 cases without pleura] effusion of patients, with acute myocardial infarction were for control. The clinical characteristics, coronary artery lesions, prognosis and treatment methods were compared. Results Patients with acute anterior wall myocardial infarction were easier complicated with pleural effusion, in addition, concerned with delayed-use diuretic, and infarct-areas. The higher troponin levels, the greater chance of pericardial effusion. Tlloracic drainage, application of noninvasive ventilator and infusion of albumin can effectively alleviate respiratory difficulties, shorten hospital stay and reduce mortality. Conclusion Patients of acute myocardial infarction complicated with Pleural effusions are not uncommon, may relate with large area infarction, diuretic using delay. Timely detection and effective treatment .can improve the prognosis.