延迟急诊PCI治疗急性ST段抬高型心肌梗死及患者预后的研究.doc

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1、延迟急诊PCI治疗急性ST段抬高型心肌梗死及患者预后的研究【摘要】目的探?延迟急诊经皮冠状动脉介入治疗(PCI)急性ST段抬高型心肌梗死(STEMI)的疗效及预后情况。方法100例急性STEMI患者，按照PCI时机将其分为延迟组(45例)和溶栓组(55例)。延迟组患者发病12〜24h内被确诊，并立即行PCI治疗；溶栓组患者发病6h内被确诊，并行溶栓药物治疗，择期行PCI治疗。对两组患者PCI治疗前后梗死相关动脉(IRA)情况［以心肌梗死溶栓试验(TIMI)分级评价］和并发症发生情况进行比较。结果PCI治疗前IRA情况比较，延迟组TIMI0〜1级所占比例100.0%明显高于

2、溶栓组61.8%,差异有统计学意义(P0.05)。延迟组严重心力衰竭、恶性心律失常发生率26.7%、28.9%高于溶栓组9.1%、9.1%,差异均有统计学意义(P0.05)o结论延迟急诊PCI应用于急性STEMI的治疗中有助于及吋疏通IRA,梗死后心绞痛发生率与早期溶栓成功再行PCI相当，不过术后严重心力衰竭、恶性心律失常的发生率较高。【关键词】延迟急诊经皮冠状动脉介入治疗；急性ST段抬高型心肌梗死；梗死相关动脉；并发症［Abstract】ObjectiveToexplorethecurativeeffectofdelayemergencypercutaneouscoro

3、naryintervention(PCI)inthetreatmentofacuteSTsegmentelevationmyocardialinfarction(STEMI)anditsprognosis・MethodsAtotalof100acuteSTEMIpatientsweredividedbyPCItimingintodelaygroup(45cases)andthrombolysisgroup(55cases).Thedelaygrouphadpatientsconfirmedwithin12~24handtheyreceivedPCItherapyimmed

4、iately.Thethrombolysisgrouphadpatientsconfirmedwithin6h,andtheyreceivedthrombolyticdrugsandselectivePCItherapy.Comparisonweremadeoninfarctionrelatedartery(IRA)condition[evaluatedbythrombolysisinmyocardialinfarction(TIMI)]andoccurrenceofcomplicationsbeforeandafterPCIintwogroups・ResultsComp

5、arisoninIRAconditionbeforePCI,thedelaygrouphadobviouslyhigherTIMIproportionofgrade0〜1as100.0%than61.8%inthrombolysisgroup,andthedifferencehadstatisticalsignificance(P0.05)・Thedelaygrouphadhigherincidenceofsevereheartfailureandmalignantarrhythmiaas26.7%and28.9%than9.1%and9.1%inthrombolysis

6、group(P0.05).ConclusionApplicationofdelayemergencyPCIinacuteSTEMItreatmenthelpstimelydredgeIRA,andtheincidenceofanginapectorisafterinfarctionisequeltoearlysuccessfulthrombolysisandPCI.Whileithashighincidenceofsevereheartfailureandmalignantarrhythmia.【Keywords】Delayemergencypercutaneouscor

7、onaryinterventiontherapy；AcuteSTsegmentelevationmyocardialinfarction；Infarctionrelatedartery；Complications急性PCI是临床上治疗急性STEMI的有效方法，但是部分患者由于路途较远等因素可能会耽误治疗的最佳时机，则需要给予延迟急诊PCI治疗。本文对本院治疗的急性STEMI患者进行研究，对比延迟急诊PCI治疗与溶栓后行PCI治疗的预后，为其临床治疗提供参考和依据，报告如下。1资料与方法1.1一般资料此次研究对象选择100例20