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目的:探讨急诊经皮冠状动脉腔内成形术(PTCA)治疗急性心肌梗死(AMI)的临床疗效。方法:回顾性分析我院自1999年6月至2000年4月急诊经皮冠状动脉腔内成形术(PTCA)治疗急性心肌梗死(AMI)的临床资料。结果:21例患者中,手术成功20例(成功率为95%)。PTCA成功者均获TIMI 3级血流,平均症状出现至血管开通时间为7.6±5.4小时。21例置入20枚冠状动脉内支架,支架置入率为95%;1例支架脱落在左主干与回旋支交界处,经用双钢丝技术撤出。1例心源性休克患者PTCA后成功置入支架,术后因顽固性室速、室颤而死亡。患者平均住院时间为14±6天。结论:急诊PTCA成功率高,手术并发症少,可使梗死相关血管(IRA)充分有效地开通,缩短住院时间,在一定程度上减少了住院费用。
Objective: To investigate the clinical efficacy of emergency percutaneous transluminal coronary angioplasty (PTCA) in the treatment of acute myocardial infarction (AMI). Methods: The clinical data of acute myocardial infarction (AMI) treated by emergency percutaneous transluminal coronary angioplasty (PTCA) in our hospital from June 1999 to April 2000 were retrospectively analyzed. Results: Of the 21 patients, 20 were successfully operated (95% success rate). PTCA successful patients were TIMI grade 3 blood flow, the average symptom onset to vascular opening time of 7.6 ± 5.4 hours. 21 cases were placed in 20 coronary stents, stent placement rate was 95%; 1 case of stent off at the junction of the left main and the circumflex artery, with double wire technology withdrawal. One patient with cardiogenic shock was successfully placed in the stent after PTCA, and died of intractable ventricular tachycardia and ventricular fibrillation after operation. The average hospital stay was 14 ± 6 days. Conclusion: The success rate of emergency PTCA is high, and the number of operative complications is small. The infarction-related blood vessel (IRA) can be fully and effectively opened, which can shorten the length of hospital stay and reduce the cost of hospitalization to a certain extent.