经微导管和穿孔球囊给药技术在STEMI患者急诊PCI治疗无复流中的应用  

Application of microcatheter and perforated balloon administration in patients with T-segment elevation myocardial infarction without reflow during emergency percutaneous coronary intervention

作　　者：许鹏 董鼎宇 穆新润 XU Peng;DONG Ding-yu;MU Xin-run(Department of Cardiovascular Medicine,Jingyang County Hospital,Xianyang 713700,Shaanxi,CHINA)

机构地区：[1]泾阳县医院心血管内科,陕西咸阳713700

出　　处：《海南医学》2023年第19期2784-2787,共4页Hainan Medical Journal

基　　金：陕西省科技攻关基金资助项目(编号:2016SF-110)。

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者在急诊经皮冠状动脉介入术(PCI)治疗中发生无复流时经微导管和穿孔球囊给药的临床效果。方法回顾性分析2020年1月至2022年9月在泾阳县医院心血管内科急诊PCI术中出现无复流现象的82例STEMI患者的临床资料,依据给药技术不同分为对照组和研究组,每组41例,对照组患者经微导管给药,研究组患者经穿孔球囊给药。比较两组患者的给药次数、心肌梗死溶栓治疗实验(TIMI)血流3级恢复时间、除支架外的费用、术中不良反应发生率及术后6个月不良心血管事件发生情况。结果研究组患者的给药次数、TIMI血流3级恢复时间、除支架外费用分别为(1.30±0.36)次、(3.26±1.07)min、(2252.58±208.24)元,明显少(短)于对照组的(1.52±0.43)次、(4.21±1.38)min、(5136.26±263.17)元,差异均有统计学意义(P<0.05);术中,研究组患者的低血压、室性心律失常发生率分别为9.76%、0,分别与对照组的12.20%、4.88%比较,差异均无统计学意义(P>0.05);术后6个月,研究组患者因心力衰竭再入院、心源性死亡、再发心肌梗死、非计划血运重建发生率为4.88%、0、2.44%、0,分别与对照组的14.63%、2.44%、4.88%、7.32%比较,差异均无统计学意义(P>0.05)。结论STEMI患者在急诊PCI治疗术中发生无复流时,相较于经微导管给药,穿孔球囊给药更加经济、有效,且不会增加术后6个月不良心血管事件的发生概率,值得临床推广应用。Objective To investigate the clinical effect of microcatheter and perforated balloon administration in patients with acute ST-segment elevation myocardial infarction(STEMI)without reflow during emergency percutaneous coronary intervention(PCI).Methods The clinical data of 82 STEMI patients without reflow during emergency PCI in Department of Cardiovascular Medicine,Jingyang County Hospital from January 2020 to September 2022 were retrospectively analyzed.The patients were divided into a control group and a study group according to different administration techniques,with 41 patients in each group.Patients in the control group were administered by microcatheter,and those in the study group were administered by perforated balloon.The frequency of administration,time of recovering myocardial infarction thrombolytic therapy trial(TIMI)blood flow level 3,cost excluding stent,incidence of intraoperative adverse reactions,and the occurrence of adverse cardiovascular events during 6 months after surgery were compared between the two groups.Results The times of administration,the time of recovering TIMI blood flow level 3,and the cost excluding stent of the study group were(1.30±0.36)times,(3.26±1.07)min,and(2252.58±208.24)yuan,which were significantly lower than(1.52±0.43)times,(4.21±1.38)min,and(5136.26±263.17)yuan in the control group(P<0.05).During surgery,the incidence of hypotension and ventricular arrhythmias in the study group was 9.76%and 0,which showed no statistically significant difference with 12.20%and 4.88%in the control group(P>0.05).Six months after surgery,the incidence of readmission due to heart failure,cardiac death,recurrent myocardial infarction,and unplanned revascularization in the study group were 4.88%,0,2.44%,and 0,which showed no statistically significant difference with 14.63%,2.44%,4.88%,and 7.32%in the control group(P>0.05).Conclusion Compared with microcatheter administration,perforated balloon administration is more economical,effective and does not increase the incidence of adverse

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入术 微导管 穿孔球囊 不良心血管事件 

分 类 号：R542.2[医药卫生—心血管疾病]