Objective To investigate the correlation between plasma aminoterminal pro-B-type natriuretic peptide (NT-proBNP) level and severity of coronary artery lesions in patients with non-ST segment elevation myocardial infarction (NSTEMI). Methods NSTEMI patients presenting to the Emergency Department and Department of Cardiology from January 2013 to March 2017 were divided into four groups: thrombosis without stenosis, single vessel disease, double vessel diseases, and three vessel diseases. The general situation of the patients, the plasma NT-proBNP, troponin T, echocardiogram and coronary angiography results were analyzed. Results A total of 88 patients were included including 6 in thrombosis without stenosis group, 20 in single vessel disease group, 31 in double vessel diseases group, and 31 in three vessel diseases group. The NT-proBNP level, left ventricular ejection fraction, left ventricular end diastolic diameter, and coronary Gensini score in three vessel diseases group differed much from those in the other groups (P<0.05). The correlation of NT-proBNP with coronary Gensini score in all the patients was positve (t=0.663, P<0.05). Conclusion The level of plasma NT-proBNP in patients with NSTEMI is related to the severity of coronary artery disease.
目的 探讨心脏外科体外循环术后留置心外膜临时起搏导线的康复经验。 方法 选取 2015 年 9 月至 2016 年 4 月 69 例体外循环术后留置心外膜临时起搏导线患者，其中男 26 例、女 43 例，平均年龄（50.2±11.5）岁。予术前及术后干预措施、出院指导和随访，评价康复效果。 结果 患者术后平均住院时间（9.8±2.6）d，69 例患者均顺利出院，其中 57 例患者顺利拔除心外膜临时起搏器导线，1 例患者因Ⅲ度房室传导阻滞继续留置临时起搏器电极，11 例患者残留临时起搏导线出院，出院后两周随访发现 2 例患者的临时起搏导线体内残端露出体表。 结论 心外膜临时起搏电极是心脏外科术后常见的风险防范手段之一，掌握临时起搏器导线的管理及临时起搏器应用的相关知识，合理管理能有效地降低术后并发症的发生，可促进患者术后康复。做好患者宣教，避免因沟通不畅导致的医患纠纷发生。
Objective To compare the effect and degree of satisfaction of different analgesic interventions for tubes of pericardium and mediastinum removal after cardiac surgery. Methods From December 2017 to June 2018, 94 patients undergoing open heart cardiac surgery with tubes of pericardium and mediastinum were allocated randomly into three groups including a group A (32 patients), a group B (35 patients), and a group C (27 patients). In the group A, intravenous Dezocine was given as analgesics. In the group B, intravenous Dezocine plus oral ibuprofen were given. In the group C, interventions of group B plus specific nursing guidance were given. With the help of visual analogue scale (VAS), scores of pain during and after the tubes removal were collected. The degree of satisfaction and other adverse effects were also recorded. Results The VAS scores and fading time of pain in the group B were significantly lower than those of the group A (P<0.017). The score of sleeping was better in the group B as well. The VAS scores and fading time of pain in the group C were also significantly lower than those of the group A, and the scores of mood, activity as well as degree of satisfaction were all higher than those in the group A (P<0.017). The scores of activity and degree of satisfaction in the group C were higher compared with the group B (P<0.017). Conclusion Combination of intravenous Dezocine and oral ibuprofen seems to be more effective than each individual. Professional and specific nursing guidance could increase the degree of satisfaction for chest tube removal after cardiac surgery.