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目的 :比较不同再灌注治疗方案治疗急性心肌梗死 (AMI)的疗效和预后。方法 :119例采用常规药物治疗 ,5 7例行静脉溶栓、 14例行冠状动脉内溶栓 (PTCR)、 12例行急诊经皮冠状动脉成形术 (PTCA)。结果 :静脉溶栓治疗冠状动脉再通率为 5 2 .6 % ,其中 ,AMI发生 <6 h者再通率为 6 7.6 % ,>6 h者再通率仅为 2 0 %。PTCR再通率为 5 0 %。急诊 PTCA手术成功率为 91.7% ,2例植入冠状动脉支架成功。行 PTCR和急诊 PTCA者无一例术后出现心源性休克、脑卒中和死亡。结论 :再灌注治疗 AMI可使冠状动脉尽早再通 ,降低病死率 ,急诊 PTCA疗效最优 ,溶栓治疗成功的主要因素在于开始溶栓的时间和溶栓药物的选择。
Objective: To compare the efficacy and prognosis of different reperfusion regimens in the treatment of acute myocardial infarction (AMI). Methods: One hundred and thirteen patients underwent conventional medical therapy, 57 received intravenous thrombolysis, 14 undergoing coronary thrombolysis (PTCR) and 12 underwent emergency percutaneous transluminal coronary angioplasty (PTCA). Results: The recanalization rate of coronary artery was 52.6% after intravenous thrombolytic therapy. The recanalization rate was 6 7.6% in AMI <6 h and 20% in> 6 h. The PTCR recanalization rate is 50%. The success rate of emergency PTCA surgery was 91.7%, 2 cases of coronary stent implantation success. There was no postoperative cardiogenic shock, stroke and death after PTCR and emergency PTCA. Conclusion: The reperfusion therapy of AMI can make the coronary artery recanalize as soon as possible and reduce the mortality rate. The optimal effect of emergency PTCA is the best. The main factors of successful thrombolytic therapy are the time to start thrombolysis and the choice of thrombolytic drugs.