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目的:探讨急诊经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者的临床疗效和安全性。方法:对187例AMI患者行急诊PCI。所有患者术前予阿司匹林300mg,氯吡格雷300mg,术后均长期给予抗血小板聚集和降血脂等冠心病2级预防治疗。结果:单支病变57例,双支病变71例,3支病变56例,左主干病变3例。处理冠状动脉病变256处,置入支架178例(支架置入率95.2%)。185例介入治疗成功,成功率98.9%,病死率1.1%。1周、1年、3年和5年的心血管不良事件发生率分别为0.05%、1.89%、3.31%、5.83%。结论:AMI后尽早、完全开通梗死相关血管极为重要,急诊PCI使AMI患者病死率显著降低。
Objective: To investigate the clinical efficacy and safety of emergency percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: 187 patients with AMI underwent emergency PCI. All patients preoperative aspirin 300mg, clopidogrel 300mg, postoperative long-term anti-platelet aggregation and anti-hyperlipidemia prevention and treatment of coronary heart disease. Results: There were 57 cases of single vessel disease, 71 cases of double vessel disease, 56 cases of 3 lesions and 3 cases of left main disease. Treatment of coronary artery lesions at 256, placement of stent in 178 cases (stent placement rate of 95.2%). 185 cases of successful intervention, the success rate of 98.9%, the fatality rate of 1.1%. The incidence of cardiovascular adverse events at 1 week, 1 year, 3 years and 5 years were 0.05%, 1.89%, 3.31% and 5.83%, respectively. Conclusion: As soon as possible after AMI, it is very important to completely open infarct-related blood vessels. Emergency PCI can reduce the mortality of AMI patients significantly.