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目的 评价老年急性心肌梗死 (AMI)患者梗死相关动脉支架置入术的疗效及安全性。 方法 对 4 1例年龄≥ 70岁的老年急性心肌梗死患者在发病 12h以内行梗死相关动脉直接经皮冠状动脉腔内成形术 (PTCA)加冠状动脉内支架置入术。梗死相关动脉 :前降支 2 1例 (5 1 2 % ) ,回旋支 7例 (17 1% ) ,右冠状动脉 13例 (31 7% )。心肌梗死溶栓治疗临床试验 (TIMI)血流 :0级 2 9例 ,1级 7例 ,2级 5例。 结果 4 1例患者梗死相关动脉共置入支架 4 8个 ,术中死亡 1例 ,死于心源性休克 ,手术成功率 97 6 % (40 / 4 1)。术后TIMI血流 3级为 37例 (90 2 % )。住院期间死亡 1例 ,死于肾功能衰竭。临床总成功率为 95 1% (39/ 4 1)。随访 36例 ,1例出现心绞痛 ,心血管造影证实为再狭窄 ,行切割球囊成形术 ;1例出院后因充血性心力衰竭再次入院治疗 ;其余 34例未再发心绞痛。 结论 老年AMI患者梗死相关动脉PTCA加支架置入术成功率高、并发症低 ,近期临床疗效确切
Objective To evaluate the efficacy and safety of infarct-related artery stenting in elderly patients with acute myocardial infarction (AMI). Methods A total of 41 elderly patients with acute myocardial infarction (aged> 70 years) underwent PTCA and coronary stent implantation within 12 hours after the onset of infarction-related artery percutaneous transluminal coronary angioplasty (PTCA). The infarct-related arteries included 21 cases of anterior descending artery (51.2%), 7 cases of circumflex artery (17.1%) and 13 cases of right coronary artery (31.7%). Thrombolytic therapy in patients with myocardial infarction clinical trials (TIMI) blood flow: 0 29 cases, 1 7 cases, 2 5 cases. Results Forty - eight scaffolds were involved in the infarction - related artery in 41 patients. One patient died of cardiogenic shock during operation. The success rate was 97.6% (40/4 1). Postoperative TIMI blood flow grade 3 was 37 cases (90 2%). 1 patient died during hospitalization, died of renal failure. The clinical assembly rate was 95% (39/41). Follow-up was performed in 36 cases. Angina pectoris was found in 1 case. Cardiac angiography was confirmed as restenosis. Balloon angioplasty was performed. One patient was hospitalized again for congestive heart failure after discharge. The remaining 34 patients had no angina pectoris. Conclusion Elderly AMI patients with infarction-related artery PTCA stenting with high success rate, low complication, the recent clinical curative effect is accurate