急性STEMI患者分步法行急诊冠状动脉介入治疗(PCI)优缺点的临床研究.docVIP

精品论文 参考文献 急性STEMI患者分步法行急诊冠状动脉介入治疗(PCI)优缺点的临床研究 郝六一 李小娜 李学信（山西省运城市中心医院 044000） 【中图分类号】R541.4 【文献标识码】A【文章编号】1672-5085（2013）21-0156-02 【摘要】 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。 【关键词】 急性心肌梗死 急诊冠状动脉介入治疗 【Abstract】 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. 【Key words】acute ST-segment elevated myocardial infarction(STEMI);the emergency percutaneous coronary intervention(PCI). 大量循证医学证据证明，PCI能有效降低STEMI的总体死亡率，但急诊PCI术中可能