经皮冠状动脉介入治疗后无复流防治进展  

Progress in Prevention and Treatment of No-Reflow Phenomenon after Percutaneous Coronary Intervention

作　　者：马国添[1] 吴海[1] 

机构地区：[1]广西医科大学第一附属医院老年心内科,广西南宁市530021

出　　处：《中国全科医学》2011年第29期3404-3406,共3页Chinese General Practice

基　　金：广西卫生厅资助课题(Z2010341)

摘　　要：经皮冠状动脉介入治疗(PCI)后发生的无复流严重影响患者的预后。无复流的主要机制是心肌微血管闭塞,可通过冠状动脉造影、心肌呈色分级、心肌声学造影、对比增强的磁共振及CT诊断。无复流可通过减少球囊扩张、使用血小板糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)受体拮抗剂、600 mg氯吡格雷的负荷量和应用血栓抽吸导管、远端血栓保护装置等预防。无复流的治疗包括:维持稳定的血流动力学、抗凝、抗血小板聚集和扩血管治疗。本研究就近年来无复流防治进展进行综述。No-reflow phenomenon after percutaneous coronary intervention may lead to poor prognosis.The underlying cause of no-reflow is microvascular obstruction and the diagnosis of no-reflow may depend on coronary angiography,myocardial blush grade,myocardial contrast echocardiography,contrast-enhanced MRI and CT.Minimized ballon inflation,GP Ⅱb/Ⅲa inhibitors,600 mg clopidogrel preload,thrombus aspiration and distal protection device can help to prevent no-reflow phenomenon.The treatment of no-reflow phenomenon includes maintaining hemodynamic indices,anti-coagulation,anti-platelet aggregation and vasodilation.This article reviews the progress in prevention and treatment of no-reflow phenomenon after percutaneous coronary intervention in recent years.

关 键 词：无复流现象 冠心病 心脏导管插入术 血流动力学 

分 类 号：R654.33[医药卫生—外科学]