急性ST段抬高型心肌梗死患者溶栓后经皮冠状动脉介入治疗时机的选择  

Opportunity for percutaneous coronary intervention after thrombolysis in patients with actue ST-segment elevation myocardial infarction

作　　者：肖志超[1] 邹克勇[2] 蔡绍乾[1] 马业新[1] 郭小梅[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]河南大学附属南石医院

出　　处：《内科急危重症杂志》2013年第3期147-148,共2页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨急性心肌梗死静脉溶栓后紧急转诊经皮冠状动脉介入治疗(PCI)模式的科学性、有效性及安全性。方法:5例急性ST段抬高型心肌梗死(STEMI)患者在外院行静脉溶栓后经绿色通道直接送至我院心导管室行紧急PCI术,观察转运途中的安全性、术中及术后的并发症,术后即刻疗效及出院后短期随访效果。结果:溶栓后立即转诊至我院并紧急PCI的5例患者均顺利完成PCI术,住院期间未见再发缺血事件,也未见明显出血并发症,缩短了患者的住院时间,术后短期随访未见明显不良事件发生。结论:在具备抢救设备及医护人员陪同的条件下,外院STEMI患者溶栓后立即转诊实施紧急PCI术是安全的,且对患者有益,手术时间应在溶栓3h之后,根据术中情况决定术后抗血小板聚集和抗凝治疗。Objective： To investigate the feasibility, safety of the immediate angioplasty after thrombolysis in patients suffered from acute ST-segment elevation myocardial infarction （STEMI）. Methods： Five patients with acute SETMI were transferred to our catheter lab and underwent emergency percutaneous coronary intervention （PCI） immediately after thrombolysis. The safety, complications during or after operation, postoperative therapeutic effect and effects during short-term follow up were observed. Results： The PCI were successfully performed on all the 5 patients, neither ischemic nor major bleeding events were observed during the in-hospital stay, the duration of hospital stay was shortened. No adverse event was seen during the short-term follow-up. Conclusions： When the medical staff and devices are both well equipped, it is safe and beneficial to transfer the STEMI patients to accept the immediate PCI after thrombolysis, the interval between thrombolysis and PCI should be at least 3 hours. The use of the anti-platelet and anti-coagulate agents should be decided based on the situation during the operation.

关 键 词：急性ST段抬高型心肌梗死 溶栓 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]