女性原发性不孕４３９例病因分析_临床医学论文.docVIP

女性原发性不孕４３９例病因分析_临床医学论文 女性原发性不孕４３９例病因分析_临床医学论文 【摘要】 目的探讨急诊经皮冠状动脉腔内成形术(PTCA)治疗急性心肌梗死的临床价值。方法 对48例急性心肌梗死患者在发病后12 h内进行急诊PTCA，术后即刻行血管造影并进行随访(6～12个月)观察，评价其疗效。结果 48例患者共扩张57支血管，其中左前降支36支，左回旋支12支，右冠状动脉9支；完全闭塞性病变24支, 成功率为75．0%(18/24)，而不完全闭塞性病变33支，成功率97．0%（32/33）(0．05)。随访6～12个月，40例(83．3%)无靶血管再狭窄及与其相关的心绞痛、心肌梗死，8例(16．7%)因靶血管再狭窄而进行支架植入治疗。结论 急诊PTCA治疗急性心肌梗死近期疗效显著，值得临床进一步推广。 　　【关键词】血管成形术；经腔、经皮冠状动脉；急性心肌梗死；急诊 　　 　　【Abstract】 ObjectiveTo investigate the clinical value of percutaneous tranluminal coronary angioplasty(PTCA) in acute myocardial infarction． MethodsPTCA was performed with 48 patients with acute myocardial infarction within 12 h, and postoperative instantly angiography, follow-up from 6 months to 12 months were carried out to evaluate its therapeutic effect． ResultsAmong 48 patients, 57 ramus arteries were expanded, including left anterior descending branch 36 ramus, left circumflex branch 12 ramus, right coronary artery 9 ramus; Achievement ratio of fully obliterans lesion 24 ramus(18/24) was 75．0%, but non-fully obliterans lesion 33 ramus was 97．0%(32/33), there was significant difference in achievement ratio of PTCA between fully obliterans lesion and non-fully obliterans lesion(0．05).During follow-up (6 months to 12 months), 40 cases(83．3%) had not restenosis of target vessel, correlative angina pectoris,and myocardial infarction; 8 cases(16．7%) received stents implantation because of the restenosis of target vessel．ConclusionEmergency PTCA has markedly therapeutic effect in the near future in in acute myocardial infarction, and be worthy of being further spreaded． 　　【Key words】Acute myocardial infarction;Angioplasty, transluminal percutaneous coronary;Acute myocardial infarction; Emergency 　　 　　急性心肌梗死(AMI)治疗的关键是及时、有效地开通梗死相关血管，实现心肌再灌注[1]。目前实现心肌再灌注的方法包括静脉溶栓治疗和急诊介入治疗。静脉溶栓治疗简便、易行，但溶栓后冠脉开通率仅为70%左右、且恢复再灌注时间较长；而急诊冠状动脉介入治疗的冠脉开通率可达90%～95%，可快速恢复冠脉再灌注，尤其可显著降低心源性休克患者的病死率[2]。因此，急诊冠状动脉介入治疗目前已成为急性心肌梗死治疗的主要方法。本院近年来对48例急性心肌梗死患者进行急诊经皮腔内冠状动脉成形术取得了满意疗效，现报告如下。 　　1 资料与方法 　　1．1 一般资料 2005年