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目的 :观察急诊冠脉介入治疗 (PCI)的疗效及安全性。方法 :选择我科急诊收治的急性心肌梗死 (心梗 )患者 116例进行急诊PCI,其中急性前壁、前间壁心梗 6 8例 ,急性下壁心梗 4 6例 ,急性前壁并下壁心梗 2例 ;合并严重低血压或心源性休克 12例 ,依Grenuzig’s法行PCI,必要时置入冠脉内支架。结果 :本组急诊冠脉造影显示多支病变者 6 6例 ,单支病变 5 0例 ,73支前降支、4 4支右冠及 8支回旋支靶血管行PCI;38例二处以上同时行PCI。成功 10 9例 ,失败 7例 ;94例患者同时植入支架 117枚 ,1例未能通过病变。术后院内死亡 4人 ,其中 3例死于心衰、休克 ,1例死于室颤。随访 2～ 93月大多数临床症状改善。结论 :急性心肌梗死急诊介入治疗是一项恢复冠脉血流最直接、最有效的手段。对高危的心梗患者尤应加强围手术期的观察、处理 ,可降低急性心肌梗死的死亡率。
Objective: To observe the efficacy and safety of emergency percutaneous coronary intervention (PCI). Methods: A total of 116 acute myocardial infarction (AMI) patients admitted to our department were enrolled in the emergency PCI. There were 68 cases of acute anterior wall and anterior myocardial infarction, 46 cases of acute inferior myocardial infarction, Myocardial infarction in 2 cases; severe hypotension or cardiogenic shock in 12 cases, according to Grenuzig’s method of PCI, if necessary, into the coronary stent. Results: The group of acute coronary angiography showed multiple lesions 66 cases, single branch lesions 50 cases, 73 anterior descending branch, 44 right coronary and 8 branches of the target vessel for PCI; 38 cases of more than two At the same time PCI. Success in 109 cases, failure in 7 cases; 94 patients with stent implantation at the same time, 1 case failed to pass the lesion. Four patients died in hospital, of which 3 died of heart failure, shock, and 1 died of ventricular fibrillation. The majority of clinical symptoms were followed up from February to September. Conclusion: Emergency intervention for acute myocardial infarction is the most direct and effective means of restoring coronary blood flow. High-risk patients with myocardial infarction in particular should strengthen the perioperative observation and treatment, can reduce the mortality rate of acute myocardial infarction.