不同治疗方法对急性心肌梗死的预后和并发症的影响

目的探讨不同的治疗方法对急性心肌梗死的疗效和安全性。方法通过回顾性分析方法 ,对比分析接受常规治疗(152例),溶栓治疗(246例),急诊PCI(378例)治疗的急性心肌梗死患者的血管再通率、住院时间和并发症的发生率。结果平均住院时间急诊PCI组和溶栓治疗组明显短于常规治疗组(P<0.05);血管再通率常规治疗组明显低于溶栓和急诊PCI组(P<0.05),而急诊PCI组血管再通率显著高于溶栓治疗组(P<0.05);梗死后心绞痛发生率急诊PCI组显著低于溶栓治疗组和常规治疗组(P<0.05);再梗死发生率急诊PCI组显著低于溶栓组(P<0.05);急诊PCI后,中度以上心力衰竭,心源性休克以及30d病死率都显著降低(P<0.05)。皮肤黏膜出血和消化道出血溶栓治疗组显著高于急诊PCI组和常规治疗组(P<0.05),严重颅内出血溶栓组显著高于常规治疗和急诊PCI组(P<0.05)。结论 AMI行急诊PCI治疗优于溶栓和常规治疗。

The Influence of Progmpsos and Complications of Different Therapies in Patients with Acute Myocardial Infarction

Objective To investigate the efficacy and safety of different therapies in common use for acute myocardial infarction（AMI）patients. Methods The clinical data of the patients with AMI treated routine（152 cases）, thrombolytic （246 cases）and emergency percutaneous coronary intervention（PCI）（378 cases） were retrospectively analyzed. The days in-hospital, rate of repufusion and major events among patients with AMI were studied. Results The days in-hospital of emergency PCI and thrombolytic was shorter than that of routine. The reperfusion rate of ruotine was lower than that of emergency PCI and thrombolytic. The post-infarction angina of routine and thrombolytic was higher than that of emergency PCI. Re-infarction of emergency PCI was lower than that of thrombolytic. After emergency PCI, the incidence of heart failure, cardiogenic shock and mortality was decreased remarkly. The incidence of skin and digestive system in thrombolytic was higher than that of emergency PCI and routine. The incidence of cerebral hemorrhage in thrombolytic was higher than that of routine and emergency AMI. Conclusion The emergency PCI in elderly patients with AMI was effect and safety.