AMI患者转运直接PCI与易化PCI  

Should Patients be Transferred for Primary-PCI or Facilitated-PCI?

作　　者：罗常有[1] 张元春[1] 

机构地区：[1]中山大学附属东华医院心内科

出　　处：《心血管病学进展》2007年第5期727-731,共5页Advances in Cardiovascular Diseases

摘　　要：目前绝大多数临床随机实验显示,直接经皮冠状动脉介入治疗(PCI)是急性心肌梗死患者罪犯血管开通最有效的再灌注方法。然而,在现实中具有开展PCI术能力的心脏中心不多,而且分布不均衡,多分布在中心城市,大部分急性心肌梗死患者从症状初发往往被送到当地基层医院,由于溶栓简单易行,加上担心急性期的搬动,所以病人往往就地接受溶栓治疗。究竟该部分病人是否应该转运到上级医院行直接PCI治疗,转运是否安全,转运导致的治疗延迟是否会抵消PCI的优势,这些一直是大家关心和争论的问题。另外,易化PCI能解决转运实际中的时间延迟问题吗?现就上述问题结合文献作一综述。Most recent related clinical randomised trials have demonstrated that primary-PCl is the best reperfusion strategy to restore antegrade coronary blood flow in the culprit artery, of patients with AMI. Most AMI patients are firstly presented in the community hospital and receive thrombolysis treatment locally in the teal world, because of the non-homogeneous distribution of catheter laboratories, most of which are located in central cities, and because of concern about moving patients during the acute phase of myocardial infarction and the convenience of thrombolysis. Should patients with AMI be transferred for primary PCI？ Is it safe？ Will the treatment delay offset the advantages of primary-PCI？Can facilitated-PCI solve the time-delay problem？ All these are currently subjects of a lively debate. This paper summaries the evidence available with enlphasis on the afore-mentioned questions.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 转运 易化 溶栓 

分 类 号：R542.22[医药卫生—心血管疾病]