经皮冠状动脉介入术围手术期心肌保护

Percutaneous Coronary Artery Intervention Perioperative Myocardial Protection

经皮冠状动脉介入术已成为冠状动脉粥样硬化性心脏病血运重建治疗的主要方式之一,虽然经皮冠状动脉介入术解除了冠状动脉主干血管的狭窄,但心肌组织的血液灌注与心肌微循环相关,因此一个成功的经皮冠状动脉介入术应当不仅改善心外膜大血管的血流,而且应最大程度的改善心肌微循环的血液灌注,然而手术过程中的球囊扩张和支架植入术会造成心肌一过性或者永久性损伤,围手术期心肌梗死已引起介入医生的高度重视。经皮冠状动脉介入术围手术期积极的药物或器械干预有利于改善心肌组织灌注,尽可能减少心肌缺血性损伤,同时经皮冠状动脉介入术者的治疗策略也攸关重要,合理的策略可以进一步提高经皮冠状动脉介入术治疗效果,使患者受益。

Percutaneou coronary artery intervention（PCI） has been become the primary way of revascularization therapy about coronary heart disease.Although PCI gave some relief from the stenochoria of main coronary artery,owing to the relation between cardiac muscle hemoperfusion and microcirculation,the blest PCI could not only increase the epicardium blood stream,but also largely impove the microcirculation hemoperfusion.During operation the saccule distension and frame implantation can bring to the temporary or permanent injury of cardiac muscle,during operation myocardial infarction has been paid close attenion by the intervention doctor.During operation,the drug or instrument intervention can make for impoving cardiac muscle hemoperfusion,and can decrease the myocardial ischemia injury.Meanwhile,if the treatment strategy was more rational,the patient can get more benefit from the PCI therapeutic efficacy.So the therapeutic strategy about PCI operator is also very important.