急诊经皮冠状动脉介入对急性心肌梗死患者的应用效果研究

Effect and Application of Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

目的探讨急诊经皮冠状动脉介入（PCI）在急性心肌梗死（AMI）患者中的临床应用效果。方法对自2009年1月至2011年3月昆明市第三人民医院收治的71例经急诊PCI治疗的AMI患者临床资料进行回顾性分析,总结患者的治疗效果、冠状动脉血流及并发症情况。结果71例患者经PCI治疗后均获成功开通,开通时间为10.5~34.7 min,平均（22±8）min。其中2例患者存在冠状动脉心肌梗死溶栓治疗0~1级;2例患者为2级;67例患者为3级。治疗1个月内发生主要不良心脏事件5例,均为心绞痛,发生率为7.0%（5/71）,未见心肌梗死病例;发生迷走神经反射6例,发生率为8.4%（6/71）。71例患者治疗后发生咯血3例,牙龈出血3例,穿刺点血肿2例,出血或血肿发生率为11.3%（8/71）。结论 PCI可有效帮助医师及时了解并判断冠状动脉的确切病变,有助于制订进一步的临床治疗方案。

Objective To investigate the effect and application of primary percutaneous coronary intervention（ PCI） in patients with acute myocardial infarction（ AMI）. Methods In the Third People＇ s Hospital of Kunming City,71 AMI patients were chosen,whose clinical PCI material was retrospectively analyzed and the therapeutic effect and coronary blood flow and the complications were summarized.Results All of the 71 patients treated with PCI were successfully cleared,the clearing time was 10. 5-34. 7 min,the average time was（ 22. 0 ± 7. 9） min,among which 2 patients were with the presence of coronary artery thrombolysis in myocardial infarction grade 0-1; 2 patients with grade 2; 67 patients with grade 3. There were 5 cases of major adverse cardiac events within one month of the treatment,all were angina,the incidence rate was 7. 0%（ 5 /71）,there was no myocardial infarction patients; there were 6cases of vagus reflex,the incidence rate was 8. 4%（ 6 /71）; there were 3 cases of hemoptysis,3 cases of gingival bleeding,2 cases of puncture site hematoma,bleeding or hematoma incidence rate was 11. 3%（ 8 /71）. Conclusion PCI can effectively help physicians understand and judge the exact lesion of coronary artery,which is contributive to the further formulation of appropriate clinical treatment plan.