DESFECHOS CLÍNICOS DO USO DA TERAPIA FIBRINOLÍTICA PARA TRATAMENTO PRÉ-HOSPITALAR DO INFARTO AGUDO DO MIOCÁRDIO
DOI:
https://doi.org/10.14393/BJ-v37n0a2021-54047Palavras-chave:
Emergency Medical Services, Fibrinolytics, Myocardial infarction, Thrombolytic therapy.Resumo
A terapia fibrinolítica (TF) consiste numa importante forma de tratamento para casos de infarto agudo do miocárdio (IAM), especialmente nos locais em que não está disponível a intervenção coronária percutânea primária (ICPP), que trata da principal forma de tratamento e pode ser usada mesmo em pacientes com infarto agudo do miocárdio no atendimento pré-hospitalar. Objetivou-se descrever os resultados clínicos do uso da TF no atendimento pré-hospitalar no tratamento de pacientes com IAM. Esta pesquisa foi realizada em duas etapas, nas quais a primeira ocorreu com o Serviço Móvel de Urgência (SAMU) e as Unidades de Pronto Atendimento (UPA), e a segunda nos serviços hospitalares referenciados como porta de entrada para essas unidades. Os dados foram coletados de fontes secundárias. Foram considerados os desfechos clínicos da TF considerados na forma de frequências absolutas e relativas e medidas de tendência central. Os principais sinais e sintomas na admissão foram dor no peito (84,62%), sudorese (36,54%), dispneia (26,92%), hipertensão (19,23%), náusea (17,31%), mal-estar (17,31%) e êmese (13,46%). A principal característica do desconforto no peito foi a dor no peito (70,45%). O medicamento fibrinolítico administrado em todos os pacientes foi a tenecteplase. O tempo médio entre o sintoma e a porta foi de 180 minutos, enquanto a reperfusão de sintomas foi de 300 minutos e o de porta-agulha foi de 160 minutos. Quanto ao desfecho, 74,47% apresentaram melhora clínica, 19,15% faleceram, 4,25% IAM refratário e 2,13% reinfarto. A principal característica da melhora clínica foi a reversão da precordialgia (68,57%), caracterizada como critério de reperfusão miocárdica. O presente estudo apresentou os principais desfechos do uso da TF com melhora clínica daqueles pacientes que a utilizaram e os menores tempos relacionados ao desconforto torácico e à administração da TF foram responsáveis por aumentar os desfechos de melhora clínica e diminuir o desfecho óbito.
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Copyright (c) 2021 Priscila Fernandes Meireles Câmara, Marcos Antonio Ferreira Júnior, Allyne Fortes Vitor, Oleci Pereira Frota, Viviane Euzébia Pereira Santos, Giovanna Karinny Pereira Cruz
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