Comparison of the curative effect of intracoronary retrograde thrombolysis and thrombus aspiration combined with stent implantation on STEMI patients

Objective:To evaluate the short-term and long-term curative effects of precise intracoronary retrograde thrombolysis combined with stent implantation,thrombus aspiration combined with stent implantation,and traditional stent implantation in patients with acute ST-segment elevation myocardial infarction.Methods:From January 2018 to October 2019,184 patients diagnosed with acute ST-segment elevation myocardial infarction and infarction-related arterial blood flow TIMI 0 grade in the First Affiliated Hospital of Hainan Medical College and percutaneous coronary intervention(PCI)were selected.According to different surgical methods,patients were divided into intracoronary retrograde thrombolysis combined with stent implantation group(thrombolysis group,n=57 cases),thrombus aspiration combined with stent implantation group(aspiration group,n=57 cases)),traditional stent implantation group(traditional group,n=70 cases).Compare the incidence of no-reflow phenomenon after percutaneous coronary intervention,the rate of 1 hour ST_segment fall≥50%in the ECG after PCI,and the main adverse cardiovascular events(MACE)during hospitalization;compare the left ventricular end-diastolic diameter(LVEDD)、left ventricular ejection fraction(LVEF)and major adverse cardiovascular events at 1 year after PCI.Results:1.The short-term effects:The incidence of no-reflow phenomenon in the thrombolytic group was lower than that of the aspiration group and the traditional group,and the rate of 1hSTR≥50%was higher than that of the aspiration group and the traditional group,the difference was statistically significant(P<0.05).2.The long-term effects:1 year after percutaneous coronary intervention,the LVEDD of the thrombolytic group was lower than that of the aspiration group and the traditional group,while the LVEF was higher than the aspiration group and the traditional group,and the incidence of major adverse cardiovascular events in the thrombolytic group at was lowest,both the difference was statistically significant(P<0.05).Conclusion:The application of intracoronary retrograde thrombolysis combined with stent implantation in STEMI patients can reduce the occurrence of no-reflow,improve long-term cardiac function,and reduce the occurrence of major adverse cardiovascular events for short-term and long-term.