急诊经皮冠状动脉腔内成形术治疗急性心肌梗死的临床价值

目的探讨急诊经皮冠状动脉腔内成形术（PTCA）治疗急性心肌梗死的临床价值。方法对48例急性心肌梗死患者在发病后12h内进行急诊PTCA，术后即刻行血管造影并进行随访（6—12个月）观察，评价其疗效。结果48例患者共扩张57支血管，其中左前降支36支，左回旋支12支，右冠状动脉9支；完全闭塞性病变24支，成功率为75．0％（18／24），而不完全闭塞性病变33支，成功率97．0％（32／33）（P〈0．05）。随访6-12个月，40例（83．3％）无靶血管再狭窄及与其相关的心绞痛、心肌梗死，8例（16．7％）因靶血管再狭窄而进行支架植入治疗。结论急诊PTCA治疗急性心肌梗死近期疗效显著，值得临床进一步推广。

The clinical value of percutaneous tranluminal coronary angioplasty in acute myocardial infarction

Objective To investigate the clinical value of percutaneous tranluminal coronary angioplasty(PTCA)in acute myocardial infarction.Methods PTCA was performed with 48 patients with acute myocardial infarction within 12 h,and postoperative instantly angiography,follow-up from 6 months to 12 months were carried out to evaluate its therapeutic effect.Results Among 48 patients,57 ramus arteries were expanded,including left anterior descending branch 36 ramus,left circumflex branch 12 ramus,right coronary artery 9 ramus;Achievement ratio of fully obliterans lesion 24 ramus(18/24)was 75.0%,but non-fully obliterans lesion 33 ramus was 97.0%(32/33),there was significant difference in achievement ratio of PTCA between fully obliterans lesion and non-fully obliterans lesion(P<0.05).During follow-up(6 months to 12 months),40 cases(83.3%)had not restenosis of target vessel,correlative angina pectoris,and myocardial infarction;8 cases(16.7%)received stents implantation because of the restenosis of target vessel.Conclusion Emergency PTCA has markedly therapeutic effect in the near future in in acute myocardial infarction,and be worthy of being further spreaded.