经桡动脉血栓抽吸在急诊冠脉介入治疗的应用

目的在经桡动脉急诊冠脉介入治疗(PCI)中用 ZEEK 血栓抽吸导管来减少和消除急性心肌梗死(AMI)患者冠脉内的血栓,观察其效果、安全性和可行性。方法选择符合条件的 AMI 患者共16例行急诊 PCI+血栓抽吸(PT)术,同时期的16例行单纯 PCI 的同类患者设为对照组。以标准方法行急诊 PCI 和/或 PT 术,观察两组患者的心肌血流灌注情况、ST 段抬高幅度最大的心电图单导联 ST 段的抬高幅度和心肌酶 CK-MB 的峰值、术后1月、2月及3月经心脏彩色超声多普勒测定的左室射血分数(LVEF)及二尖瓣环舒张早期血流速度与舒张晚期血流速度的比值(E/A)和3个月内的临床预后。结果血栓抽吸组心肌组织再灌注情况明显改善;心肌酶峰值明显提前,术后1.5 h ST 段抬高幅度有下降趋势;术后1个月、2个月和3个月时 LVEF 和 E/A 比值有逐渐增大趋势;单纯PCI 组有1例患者出现急性血栓形成。结论血栓抽吸结合经桡动脉直接 PCI 有较好的近期及远期疗效,操作简便,值得推广。

Trans-radial thrombus-aspiration during emergency percutaneous coronary intervention in acute myocardial infarction patients

Objective To observe the effectiveness,safety and feasibility of trans radial thrombus-aspiration during emergency percutaneous coronary intervention(PCI)in acute myocardial infarction(AMI)patients.Methods Sixteen AMI patients(PT group)underwent both PCI and thrombus aspiration treatment and another 16 AMI patients(control group)underwent PCI only.Parameters as myocardial perfusion,electrocardiogram ST elevation, CK-MB,left vetricular ejection fraction(LVEF)and E/A were recorded during 3 months' follow-up.Results Compared with control group,PT group had significantly improved myocardial reperfusion,early arrived CK-MB peak,decreased amplitude of elevated ST segment,and improved LVEF and E/A.There was no acute thrombus complication in PT group.Conclusions Thrombus-aspiration during emergency PCI has good immediate and long- run effects.