血栓抽吸导管在急性心肌梗死急诊介入治疗中的应用

目的 通过血栓抽吸导管在急性心肌梗塞(AMI)患者急诊经皮冠脉介入(PCI)治疗中的应用,以评价其可行性及有效性.方法 选择2008年6月～2010年8月在该院接受急诊介入治疗的AMI患者共106例,其中急诊介入术加血栓抽吸治疗者为观察组(n=55),同期条件相当未应用血栓抽吸治疗仅行急诊介入治疗患者作为对照组(n=51),比较两组的基础资料、术后和随访期间等情况.结果 观察组在发病距血管再通时间、直接支架置入率和术后达TIMI3级血流的情况明显好于对照组,无复流率则明显减少,两组之间差异有显著性(P＜0.05).术后观察组在TnT峰值及CK-MB峰值、ST段回落率、住院期间心表、再次AMI、病死率等方面与对照组比较差异亦有显著性(P＜0.05).结论 在AMI急诊PCI中应用ZEEK血栓抽吸导管安全可行,能有效的清除冠状动脉内血栓,改善心肌组织灌注,提高患者术后心功能.

Application of thrombus aspiration catheter during primary percutaneous coronary intervention in patients with acute myocardial infarction

【Objective】 To evaluate the impact of thrombus aspiration catheter during primary percutaneous coronary intervention(PCI) in patients with acute ST-elevation myocardial infarction(STEMI).【Methods】 Among the STEMI patients underwent emergent PCI from June 2008 to August 2010,55 patients received aspiration thrombectomy were enrolled in study group,and 51 patients who only received routine PCI were enrolled in control group.The clinical data,information after operation and the follow-up data were compared between the two groups.【Results】 There were no significant differences between two groups at baseline.In the study group,stent were directly implanted and TIMI flow grade 3 was obtained with all superior to the control group,and significant difference of no-reflow/slow flow was observed between the two groups.There was lower peak serum CK-MB,TnTand faster ST segment resolution in the study group.The heart failure,reinfarction and mortality in hospital decreased in the study group.【Conclusions】 In AMI patients treated with primary PCI,application of Zeek aspiration thrombectomy catheter is safe and effective,which can lower thrombosis burden,improve distalmyocardium perfusion and cardiac function after procedure.