左主干急性闭塞15例分析  

Analysis of 15 Cases of Left Main Coronary Artery Acute Occlusion

作　　者：刘胜全[1] 李琪[1] 伊洪艳[1] 李彦红[1] 刁秀娟 黎辉[1] 

机构地区：[1]黑龙江大庆油田总医院,黑龙江大庆163000

出　　处：《中国伤残医学》2015年第9期17-19,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨左主干急性闭塞导致急性心肌梗死的治疗策略。方法：回顾性分析2003年～2013年大庆油田总医院15例由左主干急性闭塞导致的急性心肌梗死患者资料。结果：入选的15例患者术中均植入IABP辅助治疗，3例在IABP的支持下急诊行PCI术，1例存活，2例死亡，1例患者在IABP支持下行急诊冠脉搭桥术术后24小时内死亡。11例冠状动脉造影后在IABP支持下准备择期行PCI术，等待过程中2例死亡，1例未行PCI术存活出院，8例择期行PCI术，其中3例死亡，5例存活出院。结论：左主干急性闭塞的死亡率极高。对于无保护的左主干急性闭塞患者，治疗上建议首先植入IABP辅助治疗，待病情相对稳定后行PCI术是一种较好的选择。而对于有保护的左主干急性闭塞的患者，建议在IABP辅助治疗下行急诊PCI术，急诊冠脉搭桥术是一种选择，但手术要求高，死亡率高。Objective： To investigate the treatment strategy of left main artery occlusion in acute myocardial infarction. Methods： Ret- rospective analysis of 2003 to 2013 15 patients with left main artery occlusion induced acute myocardial infarction in General Hospital of Daqing Oil Field. Results： The 15 patients selected were implanted with IABP adjuvant therapy, 3 cases under the support of IABP emer- gency PCI operation, 1 patients survived, 2 patients died, 1 patients died in 24 hours IABP support downlink emergency coronary artery bypass surgery. In 11 patients after coronary angiography under the support of IABP for undergoing PCI operation, the process of waiting for death in 2 cases, 1 cases without PCI were survival, 8 patients undergoing PCI surgery 3 patients died, 5 patients were discharged.Conclusion： Mortality in patients with left main artery acute occlusion is high. For unprotected left main artery acute occlusion treatment recommendations, first implanted IABP adjuvant therapy, then PCI is a good choice when the condition is relatively stable . But for the protection of the left main artery occlusion were suggested in the IABP auxiliary treatment of descending emergency PCI operation, emer- gency coronary artery bypass surgery is an option, but the operation requirements is strict and high mortality.

关 键 词：冠状动脉左总主干 急性心肌梗死 经皮冠状动脉介入治疗 

分 类 号：R541[医药卫生—心血管疾病]