中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
5期
480-482
,共3页
张晓伏%马萍%李延丽%徐清斌
張曉伏%馬萍%李延麗%徐清斌
장효복%마평%리연려%서청빈
急性心肌梗死%急诊经皮冠状动脉介入%血栓抽吸
急性心肌梗死%急診經皮冠狀動脈介入%血栓抽吸
급성심기경사%급진경피관상동맥개입%혈전추흡
Acute myocardial infarction%Emergency percutaneous coronary intervention%Thrombus aspiration
目的 分析血栓抽吸对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入(PCI)术后临床预后的影响.方法 随机选择2009年9月至2012年1月于我院确诊为急性ST段抬高型心肌梗死并行急诊PCI治疗的患者239例,其中血栓抽吸+PCI 118例(血栓抽吸组),直接PCI组121例,对两组患者的造影及临床结果进行回顾性分析.结果 血栓抽吸组在即刻血流TIMI 3级[106(89.8％)与96(79.3％)；x2=5.026,P＜0.05]、PCI术后2h心电图ST段回落率≥50％[101 (85.6％)与90(75.2％)；x2=5.500,P＜0.05]、术后1周内射血分数≥50％ [68(57.6％)与52(43.0％)；x2 =5.130,P＜0.05]、住院期间再梗死发生率[0(0)与5(4.1％)；x2=4.980,P＜0.05]都明显优于直接PCI组,差异均有统计学意义；在平均住院时间[(l0.05±5.40)d与(10.40±5.03)d；t=-0.525,P＞0.05]、术中心室颤动发生率[4(3.4％)与3(2.5％),x2=0.174,P＞0.05]、住院期间发生心力衰竭[15(12.7％)与18(14.9％);x2=0.235,P＞0.05]、恶性心律失常[12(10.2％)与15(12.4％)；x2 =0.296,P＞0.05]及病死率[2(1.7％)与5(4.1％)；x2=1.248,P＞0.05]等方面差异均无统计学意义.结论 急性ST段抬高型心肌梗死患者行急诊PCI时应用血栓抽吸可能改善临床预后,是一种安全、有效的方法.
目的 分析血栓抽吸對急性ST段抬高型心肌梗死患者急診經皮冠狀動脈介入(PCI)術後臨床預後的影響.方法 隨機選擇2009年9月至2012年1月于我院確診為急性ST段抬高型心肌梗死併行急診PCI治療的患者239例,其中血栓抽吸+PCI 118例(血栓抽吸組),直接PCI組121例,對兩組患者的造影及臨床結果進行迴顧性分析.結果 血栓抽吸組在即刻血流TIMI 3級[106(89.8％)與96(79.3％)；x2=5.026,P＜0.05]、PCI術後2h心電圖ST段迴落率≥50％[101 (85.6％)與90(75.2％)；x2=5.500,P＜0.05]、術後1週內射血分數≥50％ [68(57.6％)與52(43.0％)；x2 =5.130,P＜0.05]、住院期間再梗死髮生率[0(0)與5(4.1％)；x2=4.980,P＜0.05]都明顯優于直接PCI組,差異均有統計學意義；在平均住院時間[(l0.05±5.40)d與(10.40±5.03)d；t=-0.525,P＞0.05]、術中心室顫動髮生率[4(3.4％)與3(2.5％),x2=0.174,P＞0.05]、住院期間髮生心力衰竭[15(12.7％)與18(14.9％);x2=0.235,P＞0.05]、噁性心律失常[12(10.2％)與15(12.4％)；x2 =0.296,P＞0.05]及病死率[2(1.7％)與5(4.1％)；x2=1.248,P＞0.05]等方麵差異均無統計學意義.結論 急性ST段抬高型心肌梗死患者行急診PCI時應用血栓抽吸可能改善臨床預後,是一種安全、有效的方法.
목적 분석혈전추흡대급성ST단태고형심기경사환자급진경피관상동맥개입(PCI)술후림상예후적영향.방법 수궤선택2009년9월지2012년1월우아원학진위급성ST단태고형심기경사병행급진PCI치료적환자239례,기중혈전추흡+PCI 118례(혈전추흡조),직접PCI조121례,대량조환자적조영급림상결과진행회고성분석.결과 혈전추흡조재즉각혈류TIMI 3급[106(89.8％)여96(79.3％)；x2=5.026,P＜0.05]、PCI술후2h심전도ST단회락솔≥50％[101 (85.6％)여90(75.2％)；x2=5.500,P＜0.05]、술후1주내사혈분수≥50％ [68(57.6％)여52(43.0％)；x2 =5.130,P＜0.05]、주원기간재경사발생솔[0(0)여5(4.1％)；x2=4.980,P＜0.05]도명현우우직접PCI조,차이균유통계학의의；재평균주원시간[(l0.05±5.40)d여(10.40±5.03)d；t=-0.525,P＞0.05]、술중심실전동발생솔[4(3.4％)여3(2.5％),x2=0.174,P＞0.05]、주원기간발생심력쇠갈[15(12.7％)여18(14.9％);x2=0.235,P＞0.05]、악성심률실상[12(10.2％)여15(12.4％)；x2 =0.296,P＞0.05]급병사솔[2(1.7％)여5(4.1％)；x2=1.248,P＞0.05]등방면차이균무통계학의의.결론 급성ST단태고형심기경사환자행급진PCI시응용혈전추흡가능개선림상예후,시일충안전、유효적방법.
Objective To evaluate the effects of thrombus aspiration on postoperative clinical prognosis of acute ST-segment elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention(PCI).Methods From September 2009 to January 2012,a total of 239 patients with STEMI undergoing emergency PCI (thrombus aspiration + PCI (n =118) and PCI (n =121)) were enrolled in this study.The angiographic and clinical results were retrospectively analyzed and compared between the two groups of patients.Results There were significant differences between the thrombns aspiration group and the PCI group on instant blood flow TIMI3 grade (106 (89.8％) vs.96 (79.3％) ; x2 =5.026,P ＜ 0.05),ST-segment depression rate at two hours after surgery (101 (85.6％) vs.90 (75.2％) ; x2 =5.500,P ＜ 0.05),ejection fraction within one week after surgery (68 (57.6％) vs.52 (43.0％) ; x2 =5.130,P ＜ 0.05),incidence of reinfarction during hospitalization (0 (0) vs.5 (4.1％) ; x2 =4.980,P ＜ 0.05).There were no significant statistical difference between the two groups on the average length of stay ((10.05 ± 5.40) d vs.(10.40 ± 5.03) d; t =-0.525,P ＞ 0.05),incidence of ventricular fibrillation during surgery (4 (3.4％) vs.3 (2.5 ％ ; x2 =0.174,P ＞ 0.05),heart failure during hospitalization (15 (12.7％) vs.18 (14.9％) ; x2 =0.235,P ＞0.05),Malignant arrhythmias (12 (10.2％) vs.15 (12.4％) ; x2 =0.296,P ＞ 0.05),and mortality rate (2 (1.7％) vs.5(4.1％);x2 =1.248,P ＞0.05).Conclusion Application of thrombus aspiration,which is a safe and effective way,may improve the clinical outcomes in acute ST-segment elevation myocardial infarction patients with emergency PCI.
