目的观察急诊直接经皮冠状动脉介入治疗(PCI)和静脉溶通后行延迟PCI冠脉血运重建术治疗急性心肌梗死(AMI)的疗效及并发症。方法因AMI住院并接受PCI治疗者72例,急诊直接PCI者20例,溶栓后梗死相关血管开通行延迟PCI者52例,直接PCI者仅处理梗死相关血管,延迟PCI者除处理梗死相关血管外,对严重狭窄的非梗死相关血管也同时进行了处理。术后随访12~24个月,观察心血管事件的发生情况。结果直接PCI和延迟PCI的梗死相关血管均成功开通血运重建,手术成功率100%。术中梗死相关冠脉血运重建术后即刻血管慢复流的发生率直接PCI组较延迟PCI组高(P<0.05),术后随访期间,7例术后6个月内发生心绞痛,5例为直接PCI,2例为延迟PCI。无再梗和死亡病例发生。结论PCI是治疗AMI的有效方法,手术成功率高,并发症少,急诊直接PCI术中冠脉血管重建术后即刻血管慢复流的发生率较延迟PCI者高,选择性的对病变血管采取PCI能取得非常好的疗效。 Objective To observe the curative effect and complications of acute percutaneous coronary intervention (PCI) and delayed PCI retrograde coronary revascularization (AMI) after emergency PCI. Methods A total of 72 hospitalized patients undergoing PCI with AMI were enrolled. Twenty patients were enrolled in the emergency PCI. Fifty-two patients with delayed PCI after thrombolysis-related artery occlusion were treated with PCI. Only PCI patients with infarction-related vessels were treated. In addition, severely stenosed non-infarcted vessels were also treated simultaneously. The patients were followed up for 12-24 months and observed the occurrence of cardiovascular events. Results Both PCI and delayed infarction-related blood vessels were successfully revascularized. The successful rate was 100%. Intraoperative infarction-related coronary revascularization immediate vascular reperfusion rate was significantly higher in the direct PCI group than in the delayed PCI group (P <0.05). During the follow-up period, angina pectoris occurred in 7 patients within 6 months after surgery, Cases of direct PCI, 2 cases of delayed PCI. No further infarction and deaths occurred. Conclusions PCI is an effective method for the treatment of AMI. The success rate of operation is high and there are few complications. The incidence of slow venous bypass immediately after coronary revascularization in emergency PCI is higher than that of delayed PCI, PCI can achieve very good curative effect.