急诊冠状动脉内支架置入治疗急性心肌梗死

目的 探讨急性心肌梗死患者急诊经皮冠状动脉内支架置入成形的安全性和有效性。资料与方法 22例急性心肌梗死患者，男16例，女6例，年龄48～90岁。其中2例合并心源性休克。梗死相关血管：左冠状动脉20支，右冠状动脉8支。22例患者25支血管(30处病变)施行了急诊经皮冠状动脉内支架置入成形术，3支血管行单纯经皮冠状动脉成形术(TPCA)治疗。结果 22例患者28支病变血管全部获得有效开通，其中25支血管(30处病变)一次性置入内支架，支架置入成功率loo％。除1例术后死亡外，2l例术前梗死相关血管平均狭窄95％，术后残余狭窄为6％，临床治疗成功率为95．5％，病死率为4．5％。对顺利出院的21例患者随访6个月．其间无心脏缺血症状发生。结论 急诊经皮冠状动脉内支架置入成形是治疗急性心肌梗死的安全有效措施，成功率高，并发症少，术后心肌再缺血发生率低，对改善患者的近期和远期预后有利。

Emergency Percutaneous Coronary Stenting for Acute Myocardial Infarction

Objective To evaluate the efficiency and safety of percutaneous coronary stenting in acute myocardial infarction (AMI) patients.Materials and Methods 22 patients with AMI were underwent percutaneous coronary stenting. Infarct-related arteries (IRA) were left coronary artery in 20, right coronary artery in 8. Among of them 25 branches of coronary artery (30 target lesions) were underwent stenting, 3 of them were underwent PTCA only. Two patient suffered from cardiogenic shock. Results Percutaneous coronary stenting was successful for every patient.28 branches of target coronary arteries in 22 patients were opened effectively, 25 branches with 30 target lesions were inserted stent in one time. The stenosis degree of IRA pre- and post- percrtaneous coronary stenting was 95% and 6% respectively, clinical procedural success rate was 95.5%, mortality rate was 4.5%. During the period of follow-up in 6 months, there was not any attack of cardiac events in 21 patients discharged from the hospital.Conclusion Emergency percutaneous coronary stenting for AMI is a safe and reliable therapeutic method with its high successful rate and low complication. The recurrent ischemia rate was lower than that of thrombolysis, it is benefit to the short-term and long-term outcome of patients with AMI.