ST段抬高型急性心肌梗死患者急诊经皮冠状动脉介入治疗中无复流现象的处理

目的 探讨ST段抬高型急性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中无复流现象发生的原因及处理方法.方法 回顾性分析18例STEMI患者急诊PCI治疗中无复流现象的发生情况.结果 18例无复流患者给予盐酸地尔硫萆、腺苷、溶栓剂等药物治疗和主动脉内反搏泵(IABP)治疗.18例患者中,术中及住院期间共死亡2例,病死率为11.1%.结论 无复流现象是STEMI患者PCI治疗中常见的合并症之一,有较高的病死率;药物和IABP的综合治疗对无复流患者有一定的疗效.

Management of no-reflow in emergency percutaneous coronary intervention for ST elevation myocardial infarction

Objective To explore the causeand management of no-reflow in emergency percutaneous coronary intervention(PCI)for ST elevation myocadial infarction(STEMI).Methods We analyzed retrospectively 220 cases with STEMl who were given emergency PCI from January 2009 to December 2006.Results No-reflow wag found in 18 of the 220 patients with STEMI during PCI,with an incidence of 8.2%;All no-reflow patients were given drug treatment(with intracoronary herbesser,adenosyl and thrombolytics)and intraaortic balloon pumping(IABP),2 out of the 18 patients died during the operations and hospital stays,with a death rate of 11.1%.Conclusion No-reflow is a common complication with a high death rate in PCI for STEMI.The location of IRA and the time from onset to reperfusion are predictors of no-fellow.Combined pharmaeological approaches,including IABP,can improve IRA anterograde flow.