Leak D, Eydt J N
Arch Intern Med. 1978 Dec;138(12):1780-2.
The effect of intermediate coronary care, with and without ECG monitoring, was compared with general medical ward care on the basis of mortality, resuscitation, and detection and treatment of arrhythmias from days 3 to 14 after admission in 2,095 cases of acute coronary heart disease. Mortality was significantly reduced (P less than .02), and number of successful resuscitations for ventricular fibrillation was increased (P less than .05) but only in the unit with monitoring. Number of arrhythmias detected was significantly increased, particularly incidence of ventricular ectopics and heart block (P less than .02). Number of arrhythmias corrected to sinus rhythm was increased, but not significantly. Death from pulmonary embolism fell (P less than .01). Review of causes of death and autopsies showed an increased proportion of deaths due to intractable heart failure and cardiogenic shock. Not only specially trained nurses, but also ECG monitoring, were necessary to obtain the benefits of this treatment.
在2095例急性冠心病患者中，比较了在有或没有心电图监测情况下的中间冠心病护理与普通内科病房护理对入院后第3天至第14天死亡率、复苏情况以及心律失常检测和治疗的影响。死亡率显著降低（P<0.02），心室颤动成功复苏次数增加（P<0.05），但仅在有监测的病房。检测到的心律失常数量显著增加，尤其是室性早搏和心脏传导阻滞的发生率（P<0.02）。恢复为窦性心律的心律失常数量增加，但不显著。肺栓塞导致的死亡人数下降（P<0.01）。对死亡原因的回顾和尸检显示，因顽固性心力衰竭和心源性休克导致的死亡比例增加。要获得这种治疗的益处，不仅需要经过专门培训的护士，还需要心电图监测。
