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经皮穿刺冠状动脉腔内血管成形术(PTCA)和冠状动脉内滴注链激酶是治疗冠心病的一种较新方法,但有部分病例可因冠状动脉损伤导致急性危重心肌梗塞(MI)而必须行急症冠状动脉旁路移植术(CABG)。本文报道17例治疗性冠状动脉插管(PTCA 与冠状动脉内输注链激酶)引起的危重 MI行急症 CABG 的经验,另有3例为诊断性冠状动脉造影术中或术后不久,具有相似的急性临床表现。资料与方法:上述20例,所谓“危重心肌梗塞”,系指持续性胸痛伴有 ST 段明显改变持续长达40分钟以上。造影发现冠状动脉主干有梗阻或夹层动脉瘤征象。最初的处理包括立即从冠状动脉内与静脉输注硝酸甘油,口服硝苯吡啶,导管操作前后行冠状动
Percutaneous transluminal coronary angioplasty (PTCA) and intracoronary drip streptokinase are a newer method of treatment of coronary heart disease, but some cases may be due to coronary artery injury leading to acute critical myocardial infarction (MI) and Emergency coronary artery bypass grafting (CABG) is required. This article reports on the experience of 17 patients with CABG in 17 patients with critical MI who have undergone coronary artery catheterization (PTCA and intracoronary infusion streptokinase) and another 3 patients with diagnostic CABG during or shortly after coronary angiography Acute clinical manifestations. Materials and Methods: The above 20 cases, the so-called “critical myocardial infarction,” refers to persistent chest pain with significant changes in ST segment lasts up to 40 minutes or more. Angiography found coronary artery obstruction or dissection aneurysm signs. Initial treatment consisted of immediate infusion of nitroglycerin from the coronary and intravenous fluids, oral nifedipine, and coronoplasty before and after catheterization