改良PCI介入治疗方案对急性STEMI患者治疗相关指标及围手术期并发症的影响

Influence of modified PCI on patients with acute ST segment elevation myocardial infarction

目的探讨改良经皮冠状动脉介入治疗(PCI)方案对急性ST段抬高心肌梗死(STEMI)患者治疗相关指标及围手术期并发症的影响。方法选取该院收治行急性ST段抬高心肌梗死患者共110例,以随机数字表法分为对照组和观察组,每组各55例。分别采用常规和改良PCI介入治疗方案;比较两组手术、门球时间(D2B),患者从就诊至球囊扩张时间(C2B)、X射线透视时间、桡动脉痉挛发生率、对比剂用量、术中并发症发生率及术后随访主要心血管不良事件(MACE)发生率等。结果观察组D2B、C2B、手术及X射线透视时间均短于对照组(P<0.05);观察组患者桡动脉痉挛发生率和对比剂用量均低于对照组(P<0.05);两组术中并发症发生率比较,差异无统计学意义(P>0.05);两组术后随访MACE发生率比较,差异无统计学意义(P>0.05)。结论改良PCI介入治疗方案治疗急性STEMI可缩短治疗用时,减少桡动脉痉挛概率,减少对比剂用量,且未增加围手术期并发症发生概率。

Objective To investigate the influence of modified PCI interventional therapy on relative index and perioperative complications in patients with acute ST segment elevation myocardial infarction（STEMI）. Methods Totally 110 patients with acute STEMI admitted to our hospital from October 2013 to October 2015 were involved in this study. Patients were randomly divided into control group which received standard treatment of PCI（n = 55） and observation group which received modified PCI treatment（n = 55）. Operation time, time of D2 B, time of C2 B, time of X-ray, incidence of radial artery spasm, amount of contrast agent, intraoperative complication rate, incidence of MACE postoperatively were recorded. Results Time of D2 B, C2 B, C2 B operation, and X-ray in the observation group were decreased significantly compared with control group（P 〈 0.05）. Incidence of radial artery spasm and amount of contrast agent used during surgery in the observation group were lower dramatically than those in the control group（P 〈 0.05）. No significant difference in incidence of intraoperative complication and follow-up MACE in the two groups was identified（P 〉 0.05）. Conclusion Modified PCI interventional therapy significantly shortens time of duration of surgery, and reduces the incidence of radial artery spasm and usage of contrast agents.