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目的:探讨和评价急性心肌梗死(AMI)急诊冠状动脉介入治疗(PCI)中联合应用远端球囊保护系统的疗效及安全性。方法:选择符合急诊PCI的AMI经冠状动脉造影明确梗死相关冠状动脉内血栓性或闭塞性病变的33例患者,远端球囊保护系统保护下抽吸血栓后再行PCI治疗(球囊成形扩张术、置入支架术),最后再抽吸血栓。结果:血栓吸引后置入支架比率为81.82%;远端球囊保护系统保护下的PCI术前术后冠状动脉TIMI血流较对照组改善明显,无复流发生率低;PCI术后临床症状明显改善,手术即刻成功率为93.94%,无心脏不良事件发生,未见与该保护系统相关的血管并发症;封堵球囊平均封堵时间为(171.55±26.84)s,移出体外血栓重量(3.71±1.25)g,以红色血栓多见。结论:联合应用远端球囊保护系统保护下的AMI急诊PCI手术即刻成功率高,未见与该保护系统相关的血管并发症,该方法较安全;AMI若冠状动脉内以血栓性或闭塞性病变为主,应积极联合使用远端球囊保护系统。
Objective: To investigate and evaluate the efficacy and safety of distal balloon protection system in acute coronary intervention (AMI) in acute myocardial infarction (AMI). Methods: Thirty-three AMI patients who underwent emergency PCI were enrolled in this study. Thirty-three patients with infarction-related thrombotic or occlusive coronary lesions undergoing coronary angiography were enrolled in this study. PCI was performed after thrombus embolization under the protection of distal balloon protection system Surgery, stent placement), and finally pumping thrombus. Results: The stent placement rate was 81.82% after thrombus aspiration. The TIMI flow in the coronary arteries protected by the distal balloon protection system was significantly improved compared with the control group, and the incidence of no-reflow was low. The clinical symptoms The success rate of operation immediately was 93.94%. No adverse cardiac events occurred. No vascular complications were found. The mean occlusion time of the balloon occlusion was (171.55 ± 26.84) s, and the thrombus weight ( 3.71 ± 1.25) g, more common in red thrombus. Conclusions: The success rate of acute PCI immediately after AMI under the protection of distal balloon protection system is high. There is no vascular complications associated with this protection system. This method is safe. If AMI is thrombotic or occlusive Lesions should be actively used in conjunction with the distal balloon protection system.