抽吸导管在急性心肌梗塞介入治疗过程中应用的效果

Effect of suck by catheter during percutaneous coronary intervention in patients with acute myocardial infarction

目的:评价抽吸导管在急性心肌梗塞(AMI)介入治疗过程中应用的效果。方法:选择2009年1月至2010年3月间AMI患者共68例。其中应用抽吸导管及冠状动脉介入治疗(PCI)的患者33例,为血栓抽吸+PCI组;另有常规PCI对照组,35例。比较两组造影结果、临床预后及心肌梗塞溶栓(TIMI)血流分级。结果:抽吸+PCI组血栓即刻消失25例,血栓减少8例。与常规PCI对照组比较,血栓抽吸术组ST回落>70%者较多(40%∶75.8%),血栓积分显著下降[(1.5±1.0)分∶(0.1±0.2)分],血栓抽吸远端血流TIMI分级显著好转[(2.0±0.6)级∶(2.8±0.4)级],P均<0.05。术中及术后无严重并发症。结论:血栓抽吸是治疗急性心肌梗塞合并血栓者的简单、有效方法,可提高PCI的治疗成功率,改善心肌再灌注,减少无复流等并发症的发生,能改善其预后。

Objective： To evaluate the suck effect by catheter during percutaneous coronary intervention（PCI） in patients with acute myocardial infarction（AMI）.Methods： A total of 68 AMI patients were enrolled from January 2009 to March 2010.There were 33 patients received PCI and suck by catheter（suck＋PCI group）;another 35 patients received routine PCI（routine PCI control group）.Results of coronary angiography,clinical effect and thrombolysis in myocardial infarction trial（TIMI） of the two groups were compared and analyzed.Results： Thrombus instantly disappeared in 25 cases and decreased in 8 cases in suck＋PCI group.Compared with routine PCI control group,ratio of ST segment resolution 70%（40% vs.75.8%） was significantly higher,thrombus score [（1.5±1.0） scores vs.（0.1±0.2） scores] significantly decreased and TIMI blood flow grades after suck site [（2.0±0.6） grades vs.（2.8±0.4） grades] significantly improved in suck＋PCI group,P0.05 all.There were no severe complications during and after operation.Conclusion： Thrombus suction is a simple and effective method for treatment of acute myocardial infarction with thrombus.It can improve successive rate of percutaneous coronary intervention,reperfusion of myocardium,decrease the incidence rates of complications such as no-reflow and improve its prognosis.