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目的:探讨药物洗脱支架在急性心肌梗死(AMI)入住我院CCU后行急诊经皮冠状动脉介入治疗(PCI)的安全性和有效性。方法:选择2007年1月至2007年12月因急性心肌梗死入住我院CCU的220例急性心肌梗死患者,其中于发病12小时内行急诊手术治疗的患者200例,急诊手术仅处理梗死相关血管的靶病变,均植入药物洗脱支架,评价手术成功率、并发症、随访期间心脏不良事件发生率、再狭窄率等。结果:200例患者急诊手术治疗均获得成功,植入支架数量为1.41±0.711枚,未发生与介入治疗有关的严重并发症,住院期间发生心源性死亡2例,非心源性死亡1例,无院内支架内血栓形成、再次心梗,临床随防7.3±1.9(5-15)个月,136例患者复查了冠状动脉造影,造影随访率72.3%,随访终点内死亡5例(死亡率2.66%),含心源性死亡3例,非心源性死亡2例,其中再发心肌梗死1例,6例患者进行了再次靶血管血运重建(3.19%)。结论:药物洗脱支架在急性心肌梗死患者行急诊PCI治疗中安全可行,且院内、术后7个月随访观察显示疗效显著,并明显降低靶血管再狭窄率。
Objective: To investigate the safety and efficacy of drug-eluting stents for emergency percutaneous coronary intervention (PCI) in our hospital after acute myocardial infarction (AMI). Methods: A total of 220 acute myocardial infarction patients admitted to CCU from January 2007 to December 2007 in our hospital were enrolled. Among them, 200 patients underwent emergency surgery within 12 hours of onset. Emergency surgery only treated infarct-related blood vessels Target lesions were implanted with drug-eluting stents to assess the success rate of surgery, complications, adverse cardiac events during follow-up, restenosis rate and so on. Results: All the 200 cases were successfully treated by emergency surgery. The number of stents implanted was 1.41 ± 0.711. There were no serious complications related to interventional therapy. Two cases of cardiac death during hospitalization and one case of noncardiac death , Without thrombosis within the hospital stent, myocardial infarction again, clinical with anti-7.3 ± 1.9 (5-15) months, 136 patients underwent coronary angiography, follow-up rate was 72.3%, 5 patients died at the end of follow-up 2.66%). There were 3 cardiac deaths, 2 non-cardiac deaths, 1 recurrent myocardial infarction and 6 revascularization (3.19%). Conclusion: The drug-eluting stent is safe and feasible in emergency PCI in patients with acute myocardial infarction. The follow-up observation at 7 months in hospital and after operation shows significant curative effect and significantly reduces the rate of target vascular restenosis.