经皮冠状动脉介入治疗中血栓抽吸导管的应用

目的 探讨经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）中出现无复流或慢复流时应用血栓抽吸导管的安全性和有效性.方法 选择行PCI时发生无复流或慢复流患者56例,随机分为抽吸组26例和对照组30例,抽吸组除常规处理外立即使用血栓抽吸导管,分析比较两组术后TIMI分级、TIMI心肌灌注（TMP）分级、心肌酶谱、ST-T改变、LVEF及随访30 d的主要心血管不良事件（main adverse cardiovascular event,MACE）发生率.结果 抽吸组TIMI及TMP分级,心肌酶谱及LVEF均优于对照组,出现缺血性ST段抬高的患者数少于对照组,差异均有统计学意义（P〈0.05）;但MACE在两组间无统计学差异（P＞0.05）.结论 PCI时出现无复流或慢复流时应用血栓抽吸导管有助于改善罪犯血管远端的心肌灌注及术后心功能,减轻慢复流或无复流对心肌的损伤.

Application of thrombus aspiration catheter to percutaneous coronary intervention

Objective To study the effects and safety of thrombus aspiration catheter on myocardial reperfusion in case of slow flow or no-reflow during percutaneous coronary interventions（PCI） in patients. Methods Fifty-six patients exhibited slow flow or no-reflow during PCI in this hospital from April 2009 to April 2012. They were randomly divided into aspiration group （26 cases） and control group （30 cases）.TIMI flow grade, TIMI myocardial perfusion （TMP）grade, myocardial enzymes（CK, CK-MB） values, left ventricular ejection fraction（LVEF）, incidence of ischemic ST segment elevation and main adverse cardiovascular event （MACE） during 30 days follow-up after operation were compared. Results The differences in TIMI, TMP, CK, CK-MB, LVEF and incidence of ischemic ST segment elevation between the two groups were statistically significant（P〈0.05）, and the aspiration group was superior in these aspects to the control group, but no significant difference was found in MACE（P〉0.05）. Conclusions The use of thrombus aspiration catheter in case of slow flow or no-reflow during PCI is an effective method to increase distal myocardium perfusion of criminal vessel, improve heart function after operation and relieve myocardial damage due to slow flow or no-reflow.