急诊PCI术中冠状动脉损伤的并发症及管理  

Complications and management of coronary artery injury during emergency percutaneous coronary intervention

作　　者：许秀婷 朱盼 邹莹莹 徐国良[3] Xu Xiuting;Zhu Pan;Zou Yingying;Xu Guoliang(Department of Cardiology,Shanxi Cardiovascular Hospital,Taiyuan 03000,Shanxi,China;Department of Cardiology,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu,China;Department of Cardiology,the First Hospital of Jilin University,Changchun 130000,Jilin,China)

机构地区：[1]山西省心血管病医院心内科,山西太原030000 [2]兰州大学第一医院心内科,甘肃兰州730000 [3]吉林大学第一医院心血管内科,吉林长春春130000

出　　处：《中国中西医结合急救杂志》2024年第1期121-125,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：急性心肌梗死(AMI)是危及人类生命健康的急危重症,及时开通梗死血管是救治成功的主要手段。急诊经皮冠脉介入术(PCI)是目前最有效的治疗AMI措施,能快速恢复心肌血供、拯救患者生命。随着PCI技术的成熟,AMI患者的生存率明显提高。但近年来,急诊PCI患者正面临巨大难题:急诊PCI术中与冠状动脉(冠脉)损伤相关的罕见且致命的并发症未能及时识别和处理,导致围术期病死率升高。而目前国内外关于处理PCI术中危急并发症的管理措施尚无统一方案,现对PCI术中与冠脉损伤相关的并发症,如冠脉穿孔、无复流、冠脉夹层、支架血栓形成的管理措施进行综述,总结国内外相关治疗措施进展,帮助术者及时、正确处理突发情况,挽救更多患者生命。Acute myocardial infarction(AMI)is a serious disease that endangers human life and health,timely opening of the infarct vessel is the main means of successful treatment.Emergency percutaneous coronary intervention(PCI)is the most effective treatment at present,which can quickly restore myocardial blood supply and save patients'lives.With the maturity of PCI treatment,the survival rate of patients with AMI has improved significantly.However,in recent years,emergency PCI operators have encountered a significant challenge:rare and fatal complications associated with coronary artery injury during emergency PCI are not promptly recognized and treated,leading to an increase in perioperative mortality.At present,there is no unified plan for the management of critical complications during PCI at home and abroad.Therefore,this paper mainly reviews the management measures of complications related to coronary artery injury during surgery,such as coronary artery perforation,non-reflow,coronary artery dissection,and stent thrombosis,and summarizes the progress of relevant treatment measures at home and abroad to help surgeons deal with emergencies timely and correctly and save more patient lives.

关 键 词：经皮冠脉介入术 冠状动脉穿孔 无复流 冠状动脉夹层 支架血栓形成 

分 类 号：R541.4[医药卫生—心血管疾病]