急性心梗直接介入治疗术中慢血流及无复流的治疗进展

Progress in the Treatment of Slow Blood Flow and no Reflow in the Treatment of Acute Myocardial Infarction

急性心肌梗死直接经皮冠脉介入治疗术中慢血流和无复流一直是亟待解决的难题,此类患者预后不佳。近年来尝试应用药物治疗手段(GPⅡb/Ⅲa受体拮抗剂、前列地尔、硝酸甘油与硝普纳、腺苷、尼可地尔、维拉帕米)及器械治疗手段(主动脉球囊反搏、远端保护及抽吸装置)取得了一定的治疗效果。其中最佳方案为GPⅡb/Ⅲa受体拮抗剂联合应用血栓抽吸治疗得到一致共识。现就其治疗进展予以综述。

Slow perfusion and no-reflow in the treatment of acute myocardial infarction with percutaneous coronary intervention has been an urgent problem to be solved, and the prognosis of such patients is poor. In recent years, attempts have been made to apply drug therapy(GP Ⅱb/Ⅲa receptor antagonist, alprostadil, nitroglycerin and nitroprusside, adenosine, nicorandil, verapamil) and device therapy(aortic balloon Beat, distal protection and suction device) have achieved a certain therapeutic effect. The best option was to obtain a consensus for the combination of GP Ⅱ b/Ⅲ a receptor antagonists and thrombus aspiration. A review of its treatment progress is now available.