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目的 研究超声溶栓溶解急性前壁心肌梗死 (AMI)梗死相关血管 (IRA)血栓的疗效。方法 入选急性前壁心肌梗死患者 32例 ,左前降支近段闭塞 2 2例 ,中段闭塞 10例。超声溶栓后IRA均行急诊PTCA。结果 超声溶栓后 2 2例IRA达TIMI3级 ,成功率为 70 % ,左前降支近段 17例 (成功率 78% ) ,中段 5例 (成功率 5 0 % )。超声溶栓成功者术后残余狭窄为 (6 5± 13% )。急诊PTCA10 0 %成功 ,残余狭窄减少至 (2 3± 17) %。超声溶栓时 ,胸痛 2例 ,耳鸣 1例。导丝与超声探头卡住而不能拔出 2例。结论 低频、高能超声波可有效溶解IRA内的血栓 ,可安全用于AMI患者 ,临床可选择应用
Objective To study the therapeutic effect of ultrasonic thrombolysis on the thrombosis of infarct-related artery (IRA) in acute anterior myocardial infarction (AMI). Methods A total of 32 patients with acute anterior myocardial infarction were enrolled in this study. Twenty-two cases were occluded in the proximal segment of the left anterior descending artery and 10 cases were occluded in the middle segment. After thrombolytic therapy, the patients underwent emergency PTCA. Results Twenty-two cases of IRA achieved TIMI grade 3 after the thrombolytic therapy. The success rate was 70%. There were 17 cases in the proximal segment of the left anterior descending artery (success rate 78%) and 5 cases in the middle segment (success rate 50%). Residual stenosis was (65 ± 13%) after successful thrombolytic therapy. Emergency PTCA10 0% success, the residual stenosis reduced to (2 3 ± 17)%. Thrombolytic ultrasound, chest pain in 2 cases, 1 case of tinnitus. Wire and ultrasonic probe stuck and can not pull out in 2 cases. Conclusion Low-frequency, high-energy ultrasound can effectively dissolve the thrombus in IRA, which can be safely used in patients with AMI.