有创压力监测对优势右冠脉STEMI PPCI术后低血压的意义

Significance of Invasive Pressure Monitoring in Low Blood Pressure of Dominant Right Coronary Artery after STEMI PPCI

目的探讨优势右冠脉急性闭塞导致的ST段抬高型心肌梗死(STEMI)患者,直接经皮冠状动脉介入(PPCI)术后低血压时,在纠正低血压的治疗过程中,有创压力监测的意义.方法 82例优势右冠脉PPCI术后低血压患者按是否依据有创压力监测数据对治疗策略进行调整,分为2组,比较2组患者在治疗过程中急性左心功能不全的发生率及纠正低血压所使用的时间.结果在纠正低血压的治疗过程中,22例未依据有创压力监测数据对治疗策略进行调整的患者中有5例出现急性左心功能不全,急性左心功能不全的发生率为22.7%,纠正低血压使用的平均时间为(53±7.2)h;60例依据有创压力监测数据对治疗策略进行调整的患者中未出现急性左心功能不全的情况,纠正低血压使用的平均时间为(36±5.6)h;2组比较差异具有统计学意义(P<0.05).结论优势右冠脉急性闭塞导致的STEMI患者,PPCI术后低血压时,在对低血压进行纠正的治疗过程中,依据有创压力监测数据对治疗策略进行调整,可以明显降低患者在治疗过程中出现急性左心功能不全的风险,同时能够更快地纠正低血压.

Objective To discuss and summarize the significance of invasive pressure monitoring in lowblood pressure of the dominant right coronary artery after STEMI PPCI,in correcting the course of treatment of lowblood pressure.Methods According to whether adjusting therapeutic strategies,82cases of dominant right coronarypatients with low blood pressure after PPCI were divided into two groups.The incidence of acute left heart failure andthe time used to correct low blood pressure in patients during the treatment were compared between two groups.Results During treatment process of correcting low blood pressure,in22cases without adjusting treatment strategyaccording to pressure monitoring data,5cases appeared acute left heart dysfunction,the incidence was22.7%,theaverage time to correct low blood pressure was(53±7.2)h.In60cases with adjusting treatment strategy accordingto pressure monitoring data,no acute left heart dysfunction was found,and the average time to correct low bloodpressure was(36±5.6)h,the difference between the two groups was statistically significant(P<0.05).Conclusion For patients with STEMI induced by acute occlusion of dominant right coronary artery,in treatmentcourse of correcting low blood pressure after PPCI,adjusting the treatment strategy according to invasive pressure monitoring data can significantly reduce the risks of acute left heart failure and correct low blood pressure faster.