急性心肌梗塞急诊冠脉内支架植入后支架血栓形成的原因及处理

目的:分析急性心肌梗塞(AMI)患者急诊冠状动脉介入术(PCI)后亚急性支架血栓形成(SST)原因,以提高对其认识和处理水平。方法:自2001年1月2008年12月我院对132例AMI患者行急诊PCI治疗,成功率98.5%(130/132)。对7例发生SST(5.3%)的患者作回顾性分析。结果:7例SST病人发病原因:冠脉血流未达TIMI3级者5例,停低分子肝素12～24h者2例。6例患者经再次急诊PCI治疗后抢救成功,1例患者静脉溶栓无效死亡。结论:急诊PCI用于急性心肌梗塞治疗有较高的成功率和较好的临床效果,但有发生SST可能,若不及时发现或处理不当可导致严重后果,应引起重视。

Causes and management of subacute stent thrombosis after percutaneous coronary intervention in patients with acute myocardiaI infractionHUANG Jian-bo,YUAN

Objective： To analyze the causes of subacute stent thrombosis （SST） after percutaneous coronary intervention in patients with acute myocardiaI infraction （AM1）. Methods： From January 2001 to December 2008, 132 patients with AMI were treated using immediate intracoronary stenting, with a procedure success rate of 98.5% （130/ 132） . SST occurred in 7 cases （5.3%）, its causes was analyzed retrospectively. Results： The causes of SST were： patients with coronary blood flow≤TIMI 2 grade were five cases, with stop low molecular heparin 12-24 h were two cases. The 6 SST cases were treated successfully using percutaneous coronary intervention again, one case was dead.Conclusion： Although intracoronary stents can be implanted successfully with a prominent clinical efficacy, but subacute stent thrombosis may occur with severe clinical outcome and special attention must be paid.