急性ST段抬高型心肌梗死心肺复苏后紧急溶栓序贯即刻冠状动脉介入治疗

Immediate angioplasty following the urgent fibrinolytic therapy after successful resuscitation in acute ST segment elevation myocardial infarction

目的:ST段抬高型心肌梗死(ST-Elevation myocardial infarction,STEMI)患者溶栓后即刻PCI治疗一直是该领域研究焦点并存在争议,研究旨在优化急性STEMI患者再灌注治疗策略。方法:因急性STEMI心脏骤停2例患者,经心肺复苏自主循环恢复后,行紧急溶栓治疗并序贯即刻PCI救治过程。结果:2例患者溶栓后梗死相关血管TIMI血流均达到II级,即刻序贯PCI进一步取得稳定而确切再灌注疗效。结论:急性STEMI心肺复苏成功后紧急溶栓序贯即刻PCI治疗安全有效,并未增加出血风险。

Objective:Early angiography with subsequent PCI if not contraindicated is the recommended standard of care after successful fibrinolysis,the crucial issue is the optimal time delay between successful lysis and PCI.Methods:Immediate angioplasty following fibrinolytic therapy after cardiopulmonary resuscitation in cardiac arrest caused by acute myocardial infarction were reported in two patients.Results:Following the urgent fibrinolytic therapy after cardiopulmonary resuscitation,coronary angiography revealed that the flow of the culprit artery met TIMI grade 2 in both patients and immediate angioplasty were completed successfully.Conclusions:Thrombolysis after successful resuscitation is effective and immediate angioplasty following fibrinolytic therapy did not increase the risk of additional bleeding.