论文部分内容阅读
目的 探讨直接、延迟经皮冠状动脉成形 (PTCA)支架植入术 (STENTING)与静脉溶栓术对急性心肌梗塞 (AMI)患者近远期疗效的差异。方法 AMI患者 53例随机分为直接PTCA/STENING组 1 6例 (A组 ) ,延迟PTCA/STENTING组 1 7例 (B组 ) ,静脉溶栓组 2 0例 (C组 )。入院后均给予相同的常规术前处理 ,B组先采用与C组相同的溶栓治疗 ,3～ 7d后行延迟PTCA/STENTING治疗 ,三组间的参数经统计学处理。结果 1 .血管再通率A与B组介入治疗后 (1 0 0 % )高于C组 (65 % ) (P <0 .0 1 ) ;2 .平均住院天数与住院期再发心肌缺血事件A组少于B与C组 ,而B组延迟PTCA/STENTING后无再发心肌缺血 ,出院时左室射血分数A组高于B与C组 (P <0 .0 1 ) ,B组又高于C组 (P <0 .0 5) ;3 .治疗后 3个月恢复正常生科学研究或工作比率A与B组高于C组 ,半年内再发心肌缺血事件A与B组少于C组 (P <0 .0 1 ) ,1年存活率、6个月再狭窄率三组间无显著差异 (P >0 .0 5)。结论 直接PTCA/STENT ING可作为AMI治疗首选 ,而延迟PTCA/STENTING治疗时间可尽明提前
Objective To investigate the short-term and long-term effects of direct and delayed percutaneous coronary angioplasty (PTCA) stent implantation (STENTING) and intravenous thrombolysis on patients with acute myocardial infarction (AMI). Methods Fifty-three AMI patients were randomly divided into direct PTCA / STENING group (group A), delayed PTCA / STENTING group (n = 17) (group B) and intravenous thrombolysis group (n = 20) The same routine preoperative treatment was given after admission. Group B received the same thrombolytic therapy as group C, and delayed PTCA / STENTING 3 to 7 days after treatment. The parameters of the three groups were statistically analyzed. The rate of revascularization was higher in group A and group B after interventional treatment (100%) than in group C (65%) (P <0.01) .2. The mean length of hospital stay and myocardial ischemia The incidence of myocardial ischemia in group A was lower than that in group B and C, while in group B, there was no recurrence of myocardial ischemia after PTCA / STENTING. The ejection fraction was higher in group A than in groups B and C (P <0.01), B Group 3 was higher than Group C (P <0.05) .3. After 3 months of treatment, the rate of return to normal normal research or working rate was higher in Group A and Group B than in Group C, and within 6 months, myocardial ischemic events A and B There was no significant difference between the three groups (P> 0.05). There was no significant difference between the three groups (P <0.01), the one-year survival rate and the six-month restenosis rate. Conclusions Direct PTCA / STENT ING can be the first choice for AMI treatment, while the delayed PTCA / STENTING treatment time can be as soon as possible