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目的:比较急诊经皮冠状动脉腔内成形术PTCA与溶栓治疗急性心肌梗死AMI的临床疗效。方法:46例AMI患者,21例行急诊PTCA治疗,25例行溶栓治疗。结果:急诊PTCA组梗死相关血管IRA成功开通的有20例,成功率为95%;溶栓组IRA再通有17例,成功率为68%,两组比较,P<0.01。出院前左心室射血分数LVEF急诊PTCA组为0.53±0.10,溶栓组为0.54±0.16,病死率分别为5%和4%,两组间差异无显著性P>0.05。急诊PTCA组的平均费用明显比溶栓组高P<0.05。结论:急诊PTCA与溶栓治疗AMI患者,可使IRA充分有效地开通,故在条件允许的医院,可优先考虑行急诊PTCA治疗AMI。
Objective: To compare the clinical efficacy of emergency percutaneous transluminal coronary angioplasty (PTCA) with thrombolytic therapy for acute myocardial infarction (AMI). Methods: 46 patients with AMI, 21 patients underwent emergency PTCA treatment, 25 patients underwent thrombolytic therapy. Results: 20 cases of infarction-related vascular IRA were successfully opened in emergency PTCA group, with a success rate of 95%. There were 17 cases of recanalization of IRA in thrombolytic group with a success rate of 68%. P <0.01. The left ventricular ejection fraction LVEF before discharge was 0.53 ± 0.10 in emergency PTCA group, 0.54 ± 0.16 in thrombolysis group, and 5% and 4% in mortality group, respectively. There was no significant difference between the two groups (P> 0.05). The average cost of emergency PTCA group was significantly higher than that of thrombolytic group (P <0.05). Conclusions: Emergency PTCA and thrombolytic therapy for patients with AMI can make IRA fully and effectively open. Therefore, emergency medical treatment of AMI may be given priority in hospitals where conditions permit.