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目的 评价冠状动脉内支架术治疗急性心肌梗塞的安全性和有效性。方法 2 8例发病在1 5～ 6 5小时的AMI患者行直接PTCA术 ,其中 2 2例置入冠状动脉内支架 ,成功率 1 0 0 %。梗塞相关血管 (IRA)的TIMI 3级血流恢复率 96 4 % ,无住院死亡。 2例合并出血 ,2例术后急性左心衰。 1 8例术后出院前重复冠脉造影示IRA无血栓形成。术后随访 1 0 1 6个月 ,3例因多支病变再次行PTCA术 ,5例 ( 1 7 8% )复发心绞痛 ,无死亡病例。结论 AMI的直接冠脉内支架术是安全有效的 ,可以改善病人的近期和远期预后。
Objective To evaluate the safety and efficacy of coronary stenting in the treatment of acute myocardial infarction. Methods Twenty-eight patients with AMI who had onset of 15-56 hours underwent direct PTCA. Among them, 22 cases were treated with coronary stent, with a success rate of 100%. Infarct-related vessels (IRA) TIMI grade 3 blood flow recovery 96 4%, no hospital deaths. 2 cases with bleeding, 2 cases of acute left heart failure. 18 cases of repeat coronary angiography before discharge showed no thrombosis of IRA. All the patients were followed up for 1016 months. Three patients underwent PTCA again due to multivessel disease, and 5 patients (17.8%) had recurrent angina without any death. Conclusion The direct coronary stenting of AMI is safe and effective, which can improve the short-term and long-term prognosis of patients.