急性心肌梗死急诊冠脉溶栓后行冠脉搭桥术12例分析

Analysis of 12 cases of coronary artery bypass grafting after emergency thrombolysis in acute myocardial infarction

目的探讨部分急性心肌梗死（AMI）急诊不适合行PC]的患者行急诊冠脉溶栓术后再行急诊或择期冠脉搭桥术的效果。方法回顾分析12例AMI急诊冠脉溶栓后行急诊或择期冠脉搭桥术患者的临床资料。结果12例中梗死相关血管再通并达到TIMIⅡ～Ⅲ级血流10例，TIMIⅢ级血流9例，TIMIⅡ级血流1例。2例应用血栓抽吸装置抽吸血栓后达到TIMIⅢ级血流。2例行急诊冠脉搭桥术，10例行择期冠脉搭桥术。结论对于部分急诊不适合行PCI术的AMI患者，先行急诊冠脉溶栓术，然后根据病情及冠脉病变特点行急诊或择期冠脉搭桥术，是一种比较好的临床治疗方法。

Objective To approach the clinic effects of emergency or time selecting coronary artery bypass grafting after emergency thrombolysis in patients with acute myocardia infarction who were incompatible emergency PCI. Methods The study retrospectively analysis the clinic data of 12 patients with acute myocardial infarction who underwent emergency or time selecting coronary artery bypass grafting after emergency thrombolysis. Results 10 patients gained coronary artery recanalization and TIMI Ⅱ～Ⅲ blood flow after emergency thrombolysis, 9 patients gained TIMI m blood flow, one patient gained TIMI Ⅱ blood flow. 2 patients gained TIMI Ⅲ blood flow by sucking thrombus with equipment of sucking thrombus. 2 patients underwent emergency coronary artery bypass grafting, 10 patients underwent time selecting coronary artery bypass grafting. Conclusion For some patients who were incompatible emergency PCI, it is reasonable clinic therapy method that patients accept emergency or time selecting coronary artery bypass grafting according to patient＇s condition and characteristics of coronary artery after emergency thrombolysis.