急性冠状动脉综合征患者急诊介入治疗临床研究

目的分析本中心急性冠状动脉综合征患者的急诊介入治疗详细特征及趋势,以便更及时、有效地救治患者。方法对在我中心实施急诊介入治疗的230例急性冠状动脉综合征患者进行分析,总结病例的临床特征、介入治疗时间窗、治疗情况及近期预后。结果平均年龄增大、高龄及高危患者增多,治疗时间窗中各时间段(发病→急诊科→导管室→首次球囊扩张)均有缩短,其中导管室→首次球囊扩张时间缩短显著;药物支架、远端保护装置、血栓抽吸器、预防性冠状动脉联合注射防止无复流药物在近两年增长迅速,无血流发生率、主要心血管事件发生率及平均住院日显著下降,同时溶栓后介入治疗较直接介入治疗各种严重出血并发症无明显增加。结论急诊介入治疗是急性冠状动脉综合征的最有效治疗方法之一,各种新型辅助技术的使用可有效预防严重并发症的发生。

Emergency percutaneous coronary intervention treatment of acute coronary syndrome patients

Objective To analyze the cases of the acute coronary syndrome treated with the emergency percutaneous coronary intervention (PCI) in this department in the past years. Methods 230 patients who suffered from the acute coronary syndrome were treated with the emergency percutaneous coronary intervention. Their clinical characteristics, operation time of PCI, operation information, and short-term prognosis were summarized. Results The average age of the patients was raised, the advanced age and high risk patients increased, the therapy time from chest pain onset to emergency visit, from emergency visit to catheter lab and from catheter lab to the first balloon angioplasty shortened, and the use of drug-eluting stent, distal protective device, aspiration thrombectomy catheter, injection of glyceryl trinitrate and diltiazem to the coronary artery became more frequent during recent 6 years. The rate of no/slow reflow and major adverse cardiac event decreased , and average length of hospital stay shortened. At the same time all kinds of hemorrhage in the patients who underwent emergency PCI after thrombolysis did not increase. Conclusion Emergency PCI is effective for acute coronary syndrome patients. The results suggest that the new adjuvant technology we used is effective to prevent complication of the acute coronary syndrome.