急性心肌梗塞的急诊介入性治疗  

The Emergency Interventional Treatment of Patients with Acute Myocardial Infarction

作　　者：郭丽君[1] 郭静萱[1] 毛节明[1] 张福春[1] 李海燕[1] 陈明哲[1] 

机构地区：[1]北京医科大学附属第三临床医院心内科,100083

出　　处：《中国心血管杂志》1996年第1期7-10,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的:评价AMI急诊介入性治疗的安全性和有效性.方法:对35例发病在2～26小时之内的AMI病人行直接PTCA7例,补救性PTCA18例,立即PTCA10例,其中2例急诊支架置入.结果:PTCA处理的成功率94.3%,IRA直径狭窄程度由术前的98.11±3.20%降至术后的17.07±10.90%(P<0.001),TIMI-3级再灌注恢复率达100%.死亡3例,无其它并发症(包括再梗塞、缺血复发、急诊CABG和出血).结论:AMI的急诊介入性治疗是安全有效的,成功率高,并发症发生率低;与溶栓疗法相比较,PTCA可迅速恢复IRA的有效再灌注,即TIMI-3级血流恢复率高;对危重AMI病人急诊PTCA治疗可降低死亡率,并可改善病人的近远期预后.Objective:This study is to evaluate the safety and effectiveness of the emergency inter-ventional therapy in patients with acute myocardial infarction (AMI). Methods: 35 patients presented within 2-26 hours of onset of AMI received PTCA, among them 7 with primary PTCA ,18 with rescuing PTCA ,10 with immediate PTCA,2 with coronary stenting. Results:The procedural success rate of PTCA was 94. 3%(33/35). The severity of the stenosis decreased from 98. 11± 3. 20%before PTCA to 17. 07±10. 90% after PTCA in IRA(P<0. 001). All of the patients recovered TIMI-3 flow(100%). In-hospital mortality was 8. 6% (3/35),no other complications(reinfarc-tion,recurrent ischemia,emergency CABG and hemorrhage). Conclusions:The emergency inter-ventional treatment of patients with AMI is safe and effective,with higher procedural success rate, lower mortality and complication rate. Compared with thrombolysis therapy,PTCA can rapidly recover the reperfusion with TIMI-3 flow in IRA. For high risk AMI patients,the emergency PTCA can decrease mortality and improve short-term and long-term prognosis.

关 键 词：急诊 介入性治疗 AMI PTCA 病人 再灌注 急性心肌梗塞 目的 结论 方法 

分 类 号：R542.22[医药卫生—心血管疾病] R654[医药卫生—内科学]