论文部分内容阅读
目的:研究调查高龄(80-89岁)非ST段抬高心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)患者行早期经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的有效性。方法:回顾分析2008年8月-2009年10月期间我院住院的66例80-89岁NSTEMI患者,冠状动脉造影检查后45例行PCI术,5例因为左主干病变或者严重的三支病变行冠脉搭桥(CABG)术,其余16例做保守治疗。发病到行介入治疗时间<72h。结果:45例行PCI术中42例成功,再血管化的成功率为63.6%,失败的3例PCI术病人中2例因导丝或球囊未能通过病变,1例为顽固性室速。共植入支架80枚,术后梗死相关动脉血流均达到TIMI2-3级。术后死亡2例(心源性休克、颅内出血各1例),死亡率为4.8%。住院期间出血并发症较高,有4(9.5%)例(穿刺部位血肿2例,消化道、颅内出血各1例)。住院期间无再发心肌梗死,偶发心绞痛2例。结论:穿刺尽管高龄(80-89岁)非ST段抬高心肌梗死冠脉早期介入主要出血事件较多,但可改善住院期间的预后。
Objective: To investigate the efficacy of early percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) in the elderly (80-89 years). Methods: A retrospective analysis of 66 hospitalized 80-89-year-old NSTEMI patients hospitalized in our hospital from August 2008 to October 2009 was performed in 45 patients undergoing coronary angiography and in 5 patients with left main disease or severe three-vessel disease Coronary artery bypass grafting (CABG) surgery, the remaining 16 cases of conservative treatment. Pathogenesis to interventional treatment time <72h. Results: Forty-two patients were successfully treated with PCI in 45 cases. The success rate of revascularization was 63.6%. Two of the three failed PCI patients failed to pass the lesion due to guide wire or balloon, and one was refractory ventricular tachycardia . A total of 80 stents were implanted, infarct-related arterial blood flow reached TIMI2-3 level. Postoperative death in 2 cases (cardiogenic shock, intracranial hemorrhage in 1 case), the mortality rate was 4.8%. Hemorrhagic complications during hospitalization were higher, 4 (9.5%) cases (puncture site hematoma in 2 cases, digestive tract, intracranial hemorrhage in 1 case). No recurrence of myocardial infarction during hospitalization, occasional angina in 2 cases. CONCLUSIONS: Puncture Although the incidence of major coronary artery involvement during early-stage myocardial infarction in elderly (80-89 years) non-ST elevation myocardial infarction is greater, prognosis during hospitalization may be improved.