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老年人急性冠脉综合征介入治疗.doc

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老年人急性冠脉综合征介入治疗

老年人急性冠脉综合征介入治疗  【摘要】   目的: 评价老年急性冠脉综合征病人(GACS)接受介入治疗的条件、并发症和近远期效果。方法: 分析1999年1月至2000年12月住院的GACS病人86例,分为早期介入治疗组26例(30.2%,住院3天内);择期介入治疗组28例(32.6%,住院3天至2周);药物治疗组32例(37.2%,C组)。比较3组病人的下列参数:年龄、病史、病重程度、IABP使用率、介入并发症、住院并发症、病死率、住院时间、随访资料(包括再住院率、病死率、介入治疗和搭桥率)。结果: 3组病人的年龄和病史基本相同(Pgt;0.05)。介入治疗组的病重程度、IABP使用率明显大于药物治疗组(Plt;0.05);住院病死率、住院时间、再住院率、随访病死率、随访介入治疗和搭桥率明显低于药物治疗组(Plt;0.05)。早期介入治疗组的病重程度和1ABP使用率明显大于择期介入治疗组(Plt;0.05),但两组的操作并发症、住院并发症和病死率无差别(Pgt;0.05)。结论: ①介入治疗能明显降低老年危重GACS病人的住院病死率和并发症,缩短住院时间,改善随访结果;②早期介入治疗是处理GACS危重症的有效方法;③提高GACS危重病人的介入治疗率是改善其整体预后的重要措施。 【关键词】 老年人急性冠脉综合征 介入治疗   The Effect of Percutaneous Coronary Revascularization on Geriatric Acute Coronary Syndrome     Abstract Objective: The purpose of the study is to evaluate the using indication, complication, immediate and longterm effect of percutaneous coronary revascularization (PCR) in geriatric patients with acute coronary syndrome (GACS). Methods: Consecutive 86 GACS patients were admitted from Jan. of 1999 to Dec. of 2000. They were divided into three groups of ① early PCR group (PCR was conducted within 3 days after admission, 26 cases, 30.2%); ② elective PCR group (PCR was completed in 3 days to 2 weeks after admission, 28 cases, 32.6%); ③ medication group (32 cases, 37.2%). Following parameters were compared between 3 groups: age, history, sickness degree, IABP rate, PCR complication, total complication, mortality, hospital time, fellowup data including readmission rate, fellowup mortality, reCABG or PCI rate. Results: The age and history were comparable among 3 groups (Pgt;0.05). The sickness degree and IABP rate in two PCR groups were obviously higher than those in the medication group (Plt;0.05), but the word mortality, hospitalization time, readmission rate, followup mortality, reCABG or PCR rate were significantly lower than those in medication group (Plt;0.05). However, the procedure complication, total complication and mortality were similar between two PCR groups. Conclusions:① PCR could significa

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