PTCA及支架植入术治疗心肌梗死并重症泵功能衰竭近期效果观察

Short-term effect of percutaneous transluminal coronary angioplasty with stent implantation in treating myocardial infarction with severe pump failure

目的探讨经皮冠状动脉血管成形术(PTCA)及支架植入术治疗心肌梗死合并重症泵功能衰竭对心功能的影响.方法分析2000年5月～2002年1月在珠江医院成功接受PTCA及支架植入术治疗的73例心肌梗死合并重症泵功能衰竭患者的临床资料,按其是否有伴发症、血管病变程度及手术的复杂程度分组,比较术前和术后7 d的左室射血分数(LvEF).结果血管病变的程度和手术的复杂程度与是否有伴发症无相关(P＞0.05).除合并慢性肾功能不全的患者,其余各组患者术前和术后7 d心功能的改善均有统计学意义(P＜0.05).不同程度的血管病变和不同手术复杂程度的患者心功能术前和术后7 d的提高均有显著差异.结论 PTCA及支架植入术能明显改善心肌梗死合并重症泵功能衰竭患者近期的心功能.

Objective To evaluate the short-term therapeutic effect of percutaneous transluminal coronary angioplasty (PTCA) with stent implantation in the treatment of myocardial infarction with severe pump failure. Methods The clinical data of 73 patients receiving PTCA and stent implantation for myocardial infarction with severity pump failure were analyzed and grouped according the occurrence of complications, degree of the vascular lesions and the complexity of the surgical procedures. Preoperative and postoperative ventricular ejection fractions (LVEF) were compared in each case. Results The degree of vascular lesions and surgical complexity were not shown to relate to the occurrence of the complications. Except in cases complicated by chronic renal dysfunction, significant improvement was achieved in the patients 7 d after the operation (P<0.05), regardless of different degrees of vascular lesions and surgical complexity. Conclusion PTCA with stent implantation is effective to improve the short-term cardiac function of patients with myocardial infarction and severe pump failure.