急诊PCI术中无复流应用血栓抽吸导管装置对远端血管抽吸处理的临床疗效

目的评价急诊经皮冠状动脉介入治疗(PCI)中应用血栓抽吸导管对相关血管无复流的疗效及安全性观察。方法将40例急性心肌梗死（AMI）PCI术中发生无复流（或慢血流）TIMI≤1级的患者分为两组，两组均在支架植入前应用血栓抽吸导管行血栓抽吸，并且均成功植入支架，支架植入后均发生无复流，其中试验组无复流发生后应用血栓抽吸装置行抽吸处理，对照组应用血栓抽吸装置在血管远端推注替罗非班与硝普钠，比较两组无复流处理后TIMI血流分级及住院期间主要心血管不良事件和出血并发症等。结果试验组TIMI血流分级优于对照组(P<0.05)； 两组住院期间主要心血管不良事件比较差异有统计学意义(P<0.05)，出血发生率比较差异无统计学意义（P>0.05）。结论AMI急诊行PCI术中无复流应用血栓抽吸导管抽吸可以改善冠状动脉血流和梗死区域的心肌再灌注，减少住院期间主要心血管事件发生率，其方法是安全有效的。

Clinical therapeutic effect of thrombus aspiration pipe device on no reflow phenomenon in distal end of coronary in emergency PCI patients

ObjectiveTo evaluate the clinical therapeutic effect and safety of thrombus aspiration pipe device on no reflow phenomenon in distal end of coronary in emergency PCI patients. MethodsForty AMI patients of no reflow phenomenon in distal end of coronary during emergency PCI (TIMI grade≤1) AMI were divided into two groups. Both groups were experienced thrombus aspiration before stent implantation， then the stent implanting achived success. Experimental group as thrombus aspiration were operated after no reflow phenomenon by thrombus aspiration pipe device. Control group were bolused tirofiban and sodium nitroprusside by thrombus aspiration pipe device. TIMI flow grade and incidence rate of major adverse cardiovascular events（MACE） and bleeding events were analyzed during hospitalization.ResultsCompared with control group，TIMI flow grade improved better in experimental group (P<0.05).The incidence of major adverse cardiovascular events（MACE） in experimental group decreased(P<0.05). The incidence of bleeding in two groups showed no significant difference（P>0.05）.ConclusionUsing thrombus aspiration pipe device on no reflow phenomenon indistal end of coronary during emergency PCI improved TIMI flow grade and myocardial reperfusion. Moreover，the incidence of major adverse cardiovascular events（MACE） during hospitalization were decreased. The method was safe and available.