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目的探讨80岁以上的高龄冠心病患者在不同时机行冠脉介入治疗围术期的疗效。方法回顾性分析2005年1月至2010年12月在本院住院的76例80岁以上冠心病患者的临床资料、PCI情况、住院期间的病死率、无复流发生率、严重心律失常和低血压的发生率等指标,按PCI的时机分为急诊PCI组(急诊组n=24)和择期PCI组(择期组n=25),进行对比观察分析。结果 76例患者中72例取得即刻影像成功(成功率94.7%),共对97支靶血管行PCI且置入支架144枚。与择期组相比,急诊组的介入技术成功率为91.7%vs98.1%,P>0.05;住院期间的病死率(16.7%vs1.9%,P<0.05)、无复流发生率(16.7%vs1.9%,P<0.05)及严重心律失常和低血压(29.2%vs9.6%,P<0.05)明显增加。结论对80岁以上的高龄冠心病患者来说,无论行急诊还是择期PCI,均是一种安全、有效的治疗手段;但高龄冠心病患者行急诊PCI时,包括病死率在内的严重并发症较择期PCI明显增高,故应积极、稳妥地推行择期介入诊疗。
Objective To investigate the effect of perioperative period of coronary intervention in patients with coronary heart disease over 80 years old at different times. Methods The clinical data of 76 patients with coronary heart disease over 80 years hospitalized from January 2005 to December 2010 in our hospital were analyzed retrospectively. The PCI, the mortality rate during hospitalization, the incidence of no-reflow, severe arrhythmia and low The incidence of blood pressure and other indicators, according to the PCI time is divided into emergency PCI group (emergency group n = 24) and elective PCI group (elective group n = 25) for comparative observation and analysis. Results Of the 76 patients, 72 achieved immediate success (94.7% success rate). A total of 97 target vessels underwent PCI with 144 stents. Compared with the elective group, the success rate of interventional technique in the emergency group was 91.7% vs98.1%, P> 0.05; the mortality rate during hospitalization (16.7% vs 1.9%, P <0.05), and the incidence of no-reflow % vs1.9%, P <0.05) and severe arrhythmia and hypotension (29.2% vs9.6%, P <0.05). Conclusion For elderly patients over 80 years of age with coronary heart disease, both emergency and elective PCI, is a safe and effective treatment; but elderly patients with coronary heart disease in emergency PCI, including serious mortality, including serious complications Compared with elective PCI was significantly higher, it should be actively and steadily promote elective interventional treatment.