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1、延遲急診PCI治療急性ST段抬高型心肌梗死及患者預(yù)后的研究【摘要】目的探?延遲急診經(jīng)皮冠狀動脈介入治療(PCI)急性ST段抬高型心肌梗死(STEMI)的療效及預(yù)后情況。方法100例急性STEMI患者，按照PCI時機將其分為延遲組(45例)和溶栓組(55例)。延遲組患者發(fā)病12?24h內(nèi)被確診，并立即行PCI治療；溶栓組患者發(fā)病6h內(nèi)被確診，并行溶栓藥物治療，擇期行PCI治療。對兩組患者PCI治療前后梗死相關(guān)動脈(IRA)情況［以心肌梗死溶栓試驗(TIMI)分級評價］和并發(fā)癥發(fā)生情況進行比較。結(jié)果PCI治療前IRA情況比較，延遲組TIMI0?1級所占比例100.0%明顯高于
2、溶栓組61.8%,差異有統(tǒng)計學(xué)意義(P0.05)。延遲組嚴(yán)重心力衰竭、惡性心律失常發(fā)生率26.7%、28.9%高于溶栓組9.1%、9.1%,差異均有統(tǒng)計學(xué)意義(P0.05)o結(jié)論延遲急診PCI應(yīng)用于急性STEMI的治療中有助于及吋疏通IRA,梗死后心絞痛發(fā)生率與早期溶栓成功再行PCI相當(dāng)，不過術(shù)后嚴(yán)重心力衰竭、惡性心律失常的發(fā)生率較高?！娟P(guān)鍵詞】延遲急診經(jīng)皮冠狀動脈介入治療；急性ST段抬高型心肌梗死；梗死相關(guān)動脈；并發(fā)癥［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是臨床上治療急性STEMI的有效方法，但是部分患者由于路途較遠(yuǎn)等因素可能會耽誤治療的最佳時機，則需要給予延遲急診PCI治療。本文對本院治療的急性STEMI患者進行研究，對比延遲急診PCI治療與溶栓后行PCI治療的預(yù)后，為其臨床治療提供參考和依據(jù)，報告如下。1資料與方法1.1一般資料此次研究對象選擇100例20
