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目的:评价血栓抽吸在急性右冠脉闭塞心肌梗死介入治疗中的临床效果和安全性。方法:将2010年1月至2014年12月南方医科大学附属南海人民医院收治的108例老年右冠脉单支近中段闭影次全闭塞患者随机分为两组:对照组(52例)予冠脉内注射替罗非班后直接置入支架,观察组(56例)予冠脉内注射替罗非班+血栓抽吸后置入支架。比较两组治疗后即刻TIMl血流、TMP、危险心肌抢救指数、术后30 d左室射血分数、30 d内主要心血管事件发生率等指标。结果:与对照组比较,观察组术后TIMl血流0~1级发生率低,TIMl血流3级和TMP 3级比例较高,危险心肌抢救指数及术后30 d左室射血分数提高,术后30 d内主要心血管事件发生率低(均P<0.05)。结论:老年急性右冠闭塞心肌梗死介入治疗中应用支架联合血栓抽吸是安全、有效的方法。
Objective: To evaluate the clinical efficacy and safety of thrombus aspiration in the interventional treatment of acute right coronary artery occlusion with myocardial infarction. Methods: From January 2010 to December 2014, 108 patients with proximal middle cerebral artery occlusion of the right coronary artery who were admitted to Nanhai People’s Hospital affiliated to Southern Medical University were randomly divided into two groups: control group (52 cases) Intracoronary injection of tirofiban directly into the stent, the observation group (56 cases) were given intracoronary injection of tirofiban + thrombus after suction into the stent. The TIMI blood flow, TMP, dangerous myocardial rescue index, left ventricular ejection fraction at 30 days and the incidence of major cardiovascular events within 30 days were compared between the two groups immediately after treatment. Results: Compared with the control group, the incidence of grade 0 ~ 1 TIMl flow in the observation group was higher than that in the control group, the ratio of TIM1 grade 3 to TMP grade 3 was higher, the risk myocardial infarction index and the left ventricular ejection fraction at 30 d The incidence of major cardiovascular events within 30 days after operation was significantly lower (all P <0.05). Conclusion: The combination of stent and thrombus aspiration in elderly patients with acute right coronary artery infarction with myocardial infarction is a safe and effective method.