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目的回顾性分析直接经皮冠状动脉介入术(直接介入术,dPCI)与溶栓联合经皮冠状动脉介入术(易化介入术,FPCI)对心肌梗死的疗效、安全性影响。方法收集发病24h内行介入治疗的急性心肌梗死(AMI)患者,比较dPCI组(A)组和FPCI组(B组)的成功率和严重并发症发生率。结果两组在成功率、出血、靶血管并发症、再梗死方面相同,无显著性差异。A组从入院到导管室时间为3.7~21.5h,平均(6.4±3.8)h,B组从入院到接受静脉溶栓治疗时间为0.5~6.3h,平均(2.4±1.6)h,A组时间明显长于B组,有显著性差异。无复流现象及导管室事件如再灌注心律失常、心室颤动、低血压等方面,A组较B组明显多,有显著性差异。结论FPCI较dPCI有相同的成功率及更好的安全性,值得推广。
Objective To retrospectively analyze the effects and safety of direct percutaneous coronary intervention (PCI) and thrombolysis combined with percutaneous coronary intervention (FPCI) on myocardial infarction. Methods Patients with acute myocardial infarction (AMI) undergoing interventional therapy within 24 hours of onset were enrolled. The success rates and the incidence of serious complications in dPCI group (A) and FPCI group (B group) were compared. Results The success rate, hemorrhage, target vascular complications, re-infarction in both groups were the same, with no significant difference. The time from admission to the catheterization in group A was 3.7-21.5 h (6.4 ± 3.8 h), and the time from admission to intravenous thrombolysis in group B was 0.5-6.3 h (mean, 2.4 ± 1.6 h) Significantly longer than the B group, a significant difference. No-reflow phenomena and catheterization events such as reperfusion arrhythmias, ventricular fibrillation, hypotension, A group was significantly more than the B group, a significant difference. Conclusions FPCI has the same success rate and better safety than dPCI, which is worth promoting.