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目的探讨急性心肌梗死(AM I)患者行急诊经皮冠状动脉介入治疗(PC I)的安全性及临床疗效。方法诊断ST段抬高AM I患者28例,急诊行PC I,开通梗死相关血管(IRA)后,原则上均行药物支架植入。同时观察住院期间心脏重要事件发生情况。结果IRA为前降支15例,左回旋支3例,右冠状动脉10例。行PC I 25例,手术成功率96.2%,共植入药物支架32枚,IRA即刻的前向血流为TIM I 3级23例,占92%。PC I术后1月内无心脏重要事件生存患者20例,4例PC I术后出现左侧心力衰竭,此4例患者左冠状动脉均存在病变;1例患者术后因非IRA出现急性闭塞而死亡。结论急诊PC I能及时开通IRA,挽救AM I患者濒死的心肌,且成功率高,病死率低,患者恢复快。PC I及药物支架的运用是AM I的一种安全、有效的治疗方法。
Objective To investigate the safety and clinical efficacy of emergency percutaneous coronary intervention (PC I) in patients with acute myocardial infarction (AMI). Methods Twenty-eight patients with ST-segment elevation AM I were diagnosed. PCI was performed in emergency department and infarction-related blood vessels (IRA) were opened. All patients underwent stent implantation. At the same time observe the occurrence of important cardiac events during hospitalization. Results IRA in 15 cases of anterior descending artery, left circumflex branch in 3 cases, right coronary artery in 10 cases. Twenty-five patients underwent PC I, with 96.2% success rate. A total of 32 drug stents were implanted. The immediate antegrade flow of the IRA was TIMI 3 grade 23 (92%). There were 20 patients with no cardiac events within 1 month after PC I operation and 4 patients with left heart failure after PCI. All 4 patients had lesions of the left coronary artery. One patient had acute occlusion of non-IRA after operation And death. Conclusions Emergency PCI can open IRA in time to rescue the dying myocardium of AMI patients with high success rate, low case fatality rate and fast recovery. The use of PC I and drug stents is a safe and effective treatment for AM I.