摘要
目的 :观察急诊经皮腔内冠状动脉成形术 (PTCA)治疗急性心肌梗死 (AMI)的效果。方法 :13例 AMI患者行急诊 PTCA治疗 ,男 10例 ,女 3例 ,年龄 38～ 85 (6 0 .2± 13.6 )岁。其中 6例并发心源性休克 ,3例系溶栓失败后行补救性 PTCA,4例不适作溶栓治疗。梗死相关血管 :前降支 9例 ,右冠状动脉 4例。结果 :PTCA成功率92 .3% ,死亡 1例。术前梗死相关血管狭窄 (98.7± 3.0 ) % ,术后残余狭窄为 (14.6± 16 .2 ) %。 3例术中发生心室颤动 ,1例出现房室传导阻滞 ,1例出现无再流现象 ,经反复冠状动脉内注射硝酸甘油后恢复。术后 1例死亡 ,11例长期生存 ,随访 1～ 18个月无心脏事件发生 ,生活质量明显改善。结论 :AMI时行急诊 PTCA成功率高 ,对溶栓禁忌证、溶栓失败或 AMI并发心源性休克者应积极行急诊 PTCA。
To treat patients with acute myocardial infarction by emergent percutaneous transluminal coronary angioplasty.Method:Of 13 patients with acute myocardial infarction (AMI) who undertook PTCA,6 patients had cardiogenic shock,3 patients were failed by thrombolysis,4 patients had contraindications to thrombolysis.Infarct related coronary artery (IRCA) were involved in 9 patients with left anterial descending artery and 4 patients with right coronary artery.Result:PTCA was succesful in 12 of 13 patients (92%).One patient with cardiogenic shock died within half an hour after shock symptoms occured.TIMI grade 3 flow of IRCA was achieved in all of 12 cased with successful PTCA.The stenosis degree of IRCA pre and post PTCA were ( 98.7 ± 3.0 )% and ( 14.6 ± 16.2 )%,respectively.During the procedures,the complications included ventricular fibrillation in 3 cases,atrioventricular block in 1 case and “no flow” phenomena in 1 case.One patient with cardiogenic shock died 7 days later.During a period of 1 to 18 months follow up,long term survivals were achieved in 11 cases ( 84.6 %).Conclusion:Emergence PTCA is an effective therapeutic measure with a high primary success rate in acute myocardial infarction.PTCA should be performed immediately after onset of acute myocardial infarction in patients with contraindications to thrombolysis,cardiogenic shock or failed thrombolysis.
出处
《临床心血管病杂志》
CSCD
北大核心
2000年第1期25-27,共3页
Journal of Clinical Cardiology
关键词
经皮腔内
冠状动脉成形术
心肌梗塞
PTCA
Percutaneous transluminal coronary angioplasty Myocardial infarction Blood vessels
