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目的:观察急性ST段抬高性心肌梗死患者(STEMI)采用急诊介入治疗与择期介入治疗的临床效果。方法:选取2010年7月至2014年3月在我院收治的176例STEMI患者,根据治疗方法分为急诊介入组(112例)和择期介入组(64例),比较两组患者术后临床效果,术后不同时间的心功能指标变化和不良反应情况。结果:治疗2 d后急诊介入组超敏C反应蛋白(hs-CRP)明显低于择期组,且两组患者的术后hs-CRP较术前均明显降低(P<0.05)。术后90 min内急诊介入组的ST段回落率明显高于择期介入组(P<0.05)。术后1周、6个月急诊介入组患者的左心室射血分数(LVEF)值明显高于择期介入组,左心室舒张末期内径(LVED)值明显低于择期介入组(P<0.05)。急诊介入组住院期间心脏破裂率、复发心肌梗死、6个月内死亡率均明显低于择期介入组(P<0.05)。结论:对于时间窗内的STEMI患者,采用急诊介入手术进行治疗,有利于提高患者术后心功能恢复,降低术后死亡等不良心血管事件的发生率。
Objective: To observe the clinical effect of emergency interventional therapy and elective interventional therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 176 STEMI patients admitted to our hospital from July 2010 to March 2014 were divided into emergency intervention group (n = 112) and elective intervention group (n = 64) according to the treatment method. The postoperative clinical outcomes of the two groups were compared Effect, changes in cardiac function indicators and adverse reactions at different times after surgery. Results: After 2 days of treatment, the hs-CRP in emergency intervention group was significantly lower than that in elective group. The postoperative hs-CRP in both groups was significantly lower than that before operation (P <0.05). The response rate of ST segment in emergency intervention group was significantly higher than that in elective intervention group (P <0.05) within 90 minutes after operation. The left ventricular ejection fraction (LVEF) was significantly higher in the emergency intervention group than in the elective intervention group at 1 week and 6 months after operation, and the LVED was significantly lower than that in the elective intervention group (P <0.05). Cardiac rupture rate and recurrent myocardial infarction were significantly lower in emergency intervention group during hospitalization than in elective intervention group (P <0.05). Conclusion: For patients with STEMI in the time window, emergency interventional therapy can improve the recovery of postoperative cardiac function and reduce the incidence of adverse cardiovascular events such as postoperative death.