CAJ | 학술논문

目的比较急性ST段抬高性心肌梗死(STEMI)患者行急诊冠状动脉介入治疗时采用分步法及直接法的优缺点。方法将2002～2006年就诊我院并按照直接法行急诊冠状动脉介入治疗的178例急性STEMI患者定义为A组。将2007～2010年就诊我院并按照分步法行急诊PCI的167例急性STEMI患者定义为B组，采用回顾性分析方法，比较两种方法术中并发症（慢复流或无复流、心律失常、心力衰竭、死亡）的发生率。结果急性STEMI患者行急诊PCI时采用分步法术中并发症发生率为11.97%，直接法术中并发症发生率为20.78%，P<0.05，有统计学意义。结论急性STEMI患者行急诊PCI时采用分步法比直接法术中并发症（慢复流或无复流、心律失常、心力衰竭、死亡）明显降低，能增加手术成功率，减少医疗纠纷。
목적비교급성ST단태고성심기경사(STEMI)환자행급진관상동맥개입치료시채용분보법급직접법적우결점。방법장2002～2006년취진아원병안조직접법행급진관상동맥개입치료적178례급성STEMI환자정의위A조。장2007～2010년취진아원병안조분보법행급진PCI적167례급성STEMI환자정의위B조，채용회고성분석방법，비교량충방법술중병발증（만복류혹무복류、심률실상、심력쇠갈、사망）적발생솔。결과급성STEMI환자행급진PCI시채용분보법술중병발증발생솔위11.97%，직접법술중병발증발생솔위20.78%，P<0.05，유통계학의의。결론급성STEMI환자행급진PCI시채용분보법비직접법술중병발증（만복류혹무복류、심률실상、심력쇠갈、사망）명현강저，능증가수술성공솔，감소의료규분。
Objective: To compare the advantages and disadvantages between the fraction step method and the direct method in patients with acute ST-segment elevated myocardial infarction(STEMI) who received the emergency percutaneous coronary intervention(PCI). Method:178 patients with acute STEMI who were treated with the direct method in emergency PCI in our hospital from 2002 to 2006 were arranged to group A,and 167 patients with acute STEMI who were treated with the fraction step method in our hospital from 2007 to 2010 were arranged to group B.We analyzed retrospectively the clinical data of the two groups and compared the ntraoperative complication rate (slow-reflow or no-reflow,arrhythmias,heart failure,death) between the fraction step method and the direct method.Result:The operative complication rate (slow-reflow or no-reflow,arrhythmias,heart failure,death)in the fraction step method was 11.97%,and it occurred in 20.78% in the direct method,P<0.05. The difference had statistical significance.Conclusion:The treatment of the fraction step method in emergency PCI decreased significantly the ntraoperative complication rate (slow-reflow or no-reflow,arrhythmias,heart failure,death)than the direct method, so it can increase the success rate of emergency PCI) and reduce medical dispute.