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对无严重并发症的91例急性心肌梗死(AMI)患者早期溶栓效果不满意,梗死范围有发展者;或经溶栓治疗后仍有心绞痛发生;或出院前作症状限制性运动试验,结果阳性伴有心绞痛者常规进行经皮冠状动成形术(percutaneous transluminal coronary angioplasty,PTCA)。施行时间为AMI早期溶栓后8h～15d(平均7±4d)。单支血管病变(SVD)40例,双支血管病变(DVD)29例及三支血管病变(TVD)22例。PTCA后发生AMI一例。紧急冠状动脉搭桥术(emergency artery bypass graphy,ECABG)2例,无一例死亡,成功率为96.7%。56例于PTCA前后作症状限制性运动试验,PTCA后运动试验明显进步。认为PTCA为AMI后溶栓效果的补充。可最大限度挽救缺血心肌,有助于缩小梗死面积。
91 patients with acute myocardial infarction without serious complications (AMI) were not satisfied with the early thrombolytic effect, the development of infarction range; or angina pectoris after thrombolytic therapy; or restricted symptoms before exercise, the test results were positive Patients with angina commonly undergo percutaneous transluminal coronary angioplasty (PTCA). Execution time for AMI after early thrombolysis 8h ~ 15d (average 7 ± 4d). 40 cases of single vessel disease (SVD), 29 cases of double vessel disease (DVD) and 22 cases of three vessel disease (TVD). An example of AMI occurs after PTCA. There were 2 cases of emergency artery bypass graphy (ECABG) without any death, the success rate was 96.7%. Fifty-six patients had symptoms-limiting exercise tests before and after PTCA, and post-PTCA motor tests improved significantly. PTCA is considered as a supplement to thrombolysis after AMI. Can maximize the rescue of ischemic myocardium, helps to reduce infarct size.