临时起搏器在经皮冠状动脉介入术治疗高风险冠状动脉病变中的作用  

The Effect of Temporary Pacemaker Supporting Percutaneous Coronary Intervention in the Treatment of High Risk Coronary Diseases

作　　者：彭育红[1] 孙家安[1] 杨莉[1] 梅静[1] 李淑荣[1] 郭晓萍[1] 汝磊生[1] 李俊峡[1] 

机构地区：[1]解放军白求恩国际和平医院心内科,石家庄050082

出　　处：《临床误诊误治》2011年第4期16-18,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨临时起搏器在经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗高风险冠状动脉病变中的临床意义。方法选择临时起搏器支持下行PCI的高危患者72例,记录临时起搏器置入情况、介入操作及围术期相关临床资料。结果 72例均成功安置临时起搏器,并保留4～48 h,其中37例急性心肌梗死(acute myocardi-al infarction,AMI)患者临时起搏23例次,占总置入起搏器例数的31.9%,占AMI置入起搏器例数的62.2%,梗死相关动脉均得到开通;35例复杂病变患者临时起搏19例次,占总置入起搏器例数的26.4%,占复杂病变置入起搏器例数的54.3%,其中78.3%的慢性血管闭塞病变血管成功开通,左主干及右冠状动脉开口病变均成功完成介入治疗。结论临时起搏器与PCI联合治疗AMI及慢性血管闭塞性病变,可减少PCI治疗中因严重心律失常引起的血流动力学变化,恢复正常心率,保证重要器官供血,降低住院病死率,提高手术安全性。Objective To investigate the clinical characteristics of the temporary pacemaker supporting percutaneous coronary intervention（PCI） in the treatment of high risk coronary diseases.Methods 72 patients implanted with temporary pacemaker in PCI were analyzed.The implantion information of temporary pacemaker was recorded,and the PCI operating procedure and related situations during periprocedure stage were observed.Results All the 72 patients were successfully implanted with temporary pacemakers,with 4 to 48 hours of reservations.23 cases were temporarily paced in 37 acute myocardial infarction（AMI） patients,and accounted for 31.9% in total cases with pacemaker implantation,and 62.2% in AMI patients with pacemaker implantation.The myocardial ischemia in the 23 patients was reperfusion.19 cases were temporarily paced in 35 complicated lesion patients,and accounted for 26.4% of the total cases with pacemaker implantation,and 54.3% in complicated lesion patients with pacemaker implantation.78.3% of chronic total vascular occlusion patients succeeded in opening lesions,and successful PCI were performed in all left main artery and right coronary artery ostial lesions.Conclusion Temporary pacemaker and PCI in treatment of AMI and chronic total occlusion diseases may change hemodynamics induced by severe arrhythmias in PCI,restore normal heart rate,guarantee blood supply to vital organs,reduce hospital mortality and improve surgical safety.

关 键 词：冠状动脉疾病 心脏起搏器 人工 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]