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目的评价血栓抽吸在急性冠脉综合征患者急诊介入术中的应用效果。方法纳入昭通市第一人民医院于2014年4月~2015年4月收治的100例急性冠脉综合征患者。按照随机数字表法随机分为常规组和血栓抽吸组两组。所有患者行急诊介入术治疗,其中,常规组行常规急诊介入术;血栓抽吸组采用急诊介入术+血栓抽吸。比较两组患者术后心肌呈色分级3级获得率、术中慢血流/无复流发生率、手术时间、支架置入个数、住院时间、术后血栓积分、左室射血分数、肌钙蛋白I(c Tn I)峰值的差异。结果与常规组相比,血栓抽吸组术后心肌呈色分级3级获得率更高,差异有统计学意义(P<0.05);血栓抽吸组相比于常规组,术中慢血流/无复流发生率更低,差异有统计学意义(P<0.05);两组手术时间、支架置入个数、住院时间差异无统计学意义(P>0.05);血栓抽吸组相比于常规组术后血栓积分更低、左室射血分数更高、c Tn I峰值更低,差异有统计学意义(P<0.05)。结论血栓抽吸在急性冠脉综合征患者急诊介入术中的应用效果确切,可有效提高急诊介入术成功率,促进心肌再灌注和心功能的改善,减少术中慢血流/无复流发生。
Objective To evaluate the effect of thrombus aspiration in the emergency interventional treatment of patients with acute coronary syndrome. Methods One hundred patients with acute coronary syndrome admitted from April 2014 to April 2015 in First People’s Hospital of Zhaotong City were enrolled. According to random number table method randomly divided into conventional group and thrombus absorption group two groups. All patients underwent emergency interventional treatment, in which, the conventional group underwent routine emergency intervention; thrombectomy group using emergency intervention + thrombus aspiration. The postoperative myocardial grading of grade 3, the rate of intraoperative slow / no-reflow, the operation time, the number of stent implantation, the length of hospital stay, the postoperative thrombosis score, the left ventricular ejection fraction, Differences in troponin I (cTn I) peaks. Results Compared with the conventional group, the rate of grade 3 myocardial necrosis in the thrombus aspiration group was significantly higher (P <0.05). Compared with the conventional group, the blood flow in the thrombus aspiration group was lower / No-reflow rate was lower, the difference was statistically significant (P <0.05); There was no significant difference in the operation time, the number of stent implantation and hospital stay between the two groups (P> 0.05) In the conventional group, the postoperative thrombosis score was lower, the left ventricular ejection fraction was higher, and the peak value of cTnI was lower. The difference was statistically significant (P <0.05). Conclusions Thrombus aspiration is effective in the emergency interventional treatment of patients with acute coronary syndrome, which can effectively improve the success rate of emergency intervention, promote the improvement of myocardial reperfusion and cardiac function, reduce the occurrence of intraoperative slow / no-reflow .