急性心肌梗塞急诊介入治疗时临时心脏起搏的应用

Probability of applying temporary cardiac pacing during percutaneous coronary intervention for acute myocardial infarction

目的:探讨急性ST段抬高性心肌梗塞(STEMI)急诊经皮冠状动脉介入治疗(PCI)时临时心脏起搏应用的概率。方法:本研究为前瞻性、对照性临床研究,连续性入选197例STEMI拟行急诊PCI的患者,发病4h内行急诊PCI的患者归入A组,发病4～12h行急诊PCI的患者归入B组。比较两组临时心脏起搏应用的差别。结果:A组入选53例,B组144例,两组基础临床资料、造影及介入治疗结果比较的情况相仿,各临床指标差异无显著性(P>0.05),A组需临时心脏起搏治疗的患者比例明显高于B组(41.5%∶23.6%,P<0.05)。结论:对急性心肌梗塞发病拟行PCI,尤其拟在4h内进行者,建议备放心脏起搏导管,在出现起搏适应证时,及时进行临时心脏起搏,以免耽误抢救。

Objective： To observe the probability of temporary cardiac pacing during emergency percutaneous coronary intervention （PCI） for acute ST elevation myocardial infarction （STEMI） patients. Methods： A total of 197 consecutive STEMI patients were randomly assigned for study. Patients undergoing emergency PCI in 4 h were assigned to group A （53 cases）, the patients undergoing emergency PCI in 4--12 h were assigned to group B （144 cases）. Compared the difference for applying temporary cardiac pacing between the two groups. Results： Baseline characteristics and angio- graphic ehalacteristics showed no significant difference between the two groups （P〉0.05）. The proportion called for temporary cardiac pacing in group A was significantly higher than that of group B （41.5% vs. 23.6%, P〈0. 05）. Conclusion： The result suggests for acute myocardial infarction patients who undergo emergency percutaneaus coronary intervention especially in 4 h must preparation cardiac pacing pipe, when cardiac pacing indications occur may promptly carry out temporary cardiac pacing.