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目的研究冠脉内低频（２０ｋＨｚ）、高强度（４０Ｗ）超声溶栓在急性心肌梗死梗塞相关血管中的应用。方法急性心肌梗死患者１１例（前壁心梗６例，下壁心梗５例），梗塞相关血管前向血流均为ＴＩＭＩ０级和１级（左前降支６例，左回旋支２例，右冠状动脉３例），超声溶栓后行急诊经皮腔内冠状动脉成形术（ＰｒｉｍａｒｙＰＴＣＡ）。结果冠脉内超声溶栓对梗塞相关血管的开通率为７３％（血流达ＴＩＭＩ３级），残余狭窄为（７２±１４）％，１１例全部立即行ＰＴＣＡ，超声溶栓失败的３例经ＰＴＣＡ后血管全部开通，ＰＴＣＡ术后残余狭窄为（２４±１２）％。冠脉内超声溶栓时，因超声探头折断，血管再度闭塞１例，冠脉轻度撕裂１例；无血管痉挛，无远端血管栓塞等并发症，也无室速、室颤等恶性事件发生。结论本研究表明冠脉内低频、高强度超声溶栓是安全、有效的血管开通方式，可应用于临床。
Objective To study the application of intracoronary low-frequency (20kHz) and high-intensity (40W) ultrasonic thrombolysis in infarct-related blood vessels of acute myocardial infarction. Methods Eleven patients with acute myocardial infarction (anterior myocardial infarction in 6 and inferior myocardial infarction in 5), infarct-related prevascular flow were TIMI grade 0 and 1 (left anterior descending artery in 6 cases, left circumflex artery in 2 cases, Right coronary artery in 3 cases), underwent thrombolysis after percutaneous transluminal coronary angioplasty (PrimaryPTCA). Results The intracoronary ultrasound thrombolysis had an open rate of 73% (TIMI grade 3) and residual stenosis (72 ± 14)%. Eleven patients underwent PTCA immediately and three failed thrombolysis All the blood vessels were opened after PTCA. The residual stenosis after PTCA was (24 ± 12)%. Coronary thrombolysis, due to ultrasound probe broken, vascular occlusion in 1 case, coronary mild tear in 1 case; no vasospasm, no complications such as distal vascular embolism, nor ventricular tachycardia, ventricular fibrillation and other malignant The incident happened. Conclusion This study shows that intracoronary low-frequency, high-intensity ultrasound thrombolysis is a safe and effective way to open the blood vessels and can be used in clinical practice.