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目的 探讨直接经皮冠状动脉 (冠脉 )介入治疗 (PCI)对急性心肌梗死 (AMI)的疗效。方法 6 3例AMI患者在发病 12h内接受梗死相关血管急诊PCI ,随访 1～ 14个月。结果 6 3例患者中6 1例 (96 .8% )介入治疗获得成功。 3例行经皮冠脉腔内成形术 (PTCA) ,5 8例置入支架。全部获得TIMI 3级血流灌注。 5例发生无血流现象 ,行冠脉内尿激酶溶栓血流改善。 5例在术中发生室速、室颤 ,4例及时除颤转复窦性心律 ,1例死亡。 5例心原性休克患者有 2例住院期死亡。随访期主要事件发生率 17% (5 / 6 0 ) ,其中 2例猝死 ,1例再梗死 ,再次接受PCI成功 ,1例接受择期CABG。 1例因支架内再狭窄行再次PCI。结论 直接PCI治疗AMI可有效地使梗死相关冠脉再通 ,成功率高 ,住院病死率低 ,近期预后良好
Objective To investigate the effect of direct percutaneous coronary intervention (PCI) on acute myocardial infarction (AMI). Methods Sixty-three patients with AMI received infarction-related vascular emergency PCI within 12 hours of onset, and were followed up for 1 to 14 months. Results Sixty-three cases (96.8%) of 6 3 patients were successful in interventional therapy. 3 cases underwent percutaneous transluminal coronary angioplasty (PTCA), 58 cases were placed in the stent. All received TIMI grade 3 perfusion. No blood flow occurred in 5 cases, and coronary artery urokinase thrombolytic blood flow improved. In 5 cases, ventricular tachycardia and ventricular fibrillation occurred in 4 cases, sinus rhythm was recovered in 4 cases and defibrillation was repeated in 4 cases. One case died. In 5 patients with cardiogenic shock, 2 were hospitalized and died. During the follow-up, the incidence of major events was 17% (5/60), of which 2 were sudden death, 1 was reinfarcted, PCI was successful again, and 1 patient underwent elective CABG. One case had PCI again due to in-stent restenosis. Conclusions Direct PCI for AMI can effectively reopen infarct-related coronary arteries with high success rate, low inpatient mortality and good prognosis in the near future