急性心肌梗塞急诊介入治疗时临时心脏起搏的应用

目的:探讨急性ST段抬高性心肌梗塞(STEMI)急诊经皮冠状动脉介入治疗(PCI)时临时心脏起搏应用的概率。方法:本研究为前瞻性、对照性临床研究,连续性入选197例STEMI拟行急诊PCI的患者,发病4h内行急诊PCI的患者归入A组,发病4～12h行急诊PCI的患者归入B组。比较两组临时心脏起搏应用的差别。结果:A组入选53例,B组144例,两组基础临床资料、造影及介入治疗结果比较的情况相仿,各临床指标差异无显著性(P0.05),A组需临时心脏起搏治疗的患者比例明显高于B组(41.5%∶23.6%,P0.05)。结论:对急性心肌梗塞发病拟行PCI,尤其拟在4h内进行者,建议备放心脏起搏导管,在出现起搏适应证时,及时进行临时心脏起搏,以免耽误抢救。

Probability of applying temporary cardiac pacing during percutaneous coronary intervention for acute myocardial infarction

Objective： To observe the probability of temporary cardiac pacing during emergency percutaneous coronary intervention （PCI） for acute ST elevation myocardial infarction （STEMI） patients. Methods： A total of 197 consecutive STEMI patients were randomly assigned for study. Patients undergoing emergency PCI in 4 h were assigned to group A （53 cases）, the patients undergoing emergency PCI in 4--12 h were assigned to group B （144 cases）. Compared the difference for applying temporary cardiac pacing between the two groups. Results： Baseline characteristics and angio- graphic ehalacteristics showed no significant difference between the two groups （P〉0.05）. The proportion called for temporary cardiac pacing in group A was significantly higher than that of group B （41.5% vs. 23.6%, P〈0. 05）. Conclusion： The result suggests for acute myocardial infarction patients who undergo emergency percutaneaus coronary intervention especially in 4 h must preparation cardiac pacing pipe, when cardiac pacing indications occur may promptly carry out temporary cardiac pacing.