急性心肌梗死急诊介入治疗与静脉溶栓治疗的近期疗效观察.docVIP

精品论文 参考文献 急性心肌梗死急诊介入治疗与静脉溶栓治疗的近期疗效观察 乔艳丽 　　安阳市中医院急诊科 河南安阳 455000 　　摘要：目的：比较急诊经皮冠状动脉介入治疗（PCI）与尿激酶（UK）静脉溶栓治疗对急性心肌梗死（AMI）患者近期的临床疗效。方法：选取本院收治的首次发生的ST段抬高的AMI患者58例，接受急诊PCI治疗（PCI组）29例，接受UK静脉溶栓治疗（UK组）29例，两组均于发病6 h内进行治疗，比较两组患者梗死相关动脉血管（IRA）再通率，院内再梗塞、心绞痛、心衰等并发症和病死率，以及两周后超声心动图结果（LVEF）。结果：急诊PCI组IRA再通率明显高于UK组，有统计学意义（P＜0.05）。院内再梗塞、心绞痛、心衰等并发症及病死率，比率明显低于UK组，有统计学意义（P＜0.05）。PCI组与UK组两周后LVEF相比，差异有统计学意义（P＜0.05）。结论：急诊PCI能够提高IRA再通率，减少并发症及病死率，优于溶栓治疗，是AMI早期再灌注安全有效的方法。 　　关键词：急性心肌梗死；急诊经皮冠状动脉介入治疗；静脉溶栓 　　Abstract：objective：to compare the emergency percutaneous coronary intervention（PCI）and urokinase（UK）intravenous thrombolytic therapy for acute myocardial infarction（AMI）patients with recent clinical curative effect.Selection methods：our hospital were analyzed for the first time of ST segment elevation of 58 patients with AMI，emergency PCI therapy（PCI group）29 cases，UK intravenous thrombolysis therapy group（UK）29 cases，both two groups from within 6 h of treatment，compared two groups of patients with infarction related artery（IRA），the rate of nosocomial and infarction，angina pectoris，heart failure and other complications and mortality，and echocardiography results（LVEF）in two weeks.Results：the IRA rate of emergency PCI group was obviously higher than that of the UK group，with statistical significance（P lt; 0.05）.Hospital again infarction，angina pectoris，heart failure and other complications and mortality，rate was lower than that in group UK，was statistically significant（P lt; 0.05）.PCI group compared with the two weeks after the UK group LVEF，the difference was statistically significant（P lt; 0.05）.Conclusion：emergency PCI can improve the IRA rate，reduce complications and mortality，better than the thrombolysis treatment，is an early reperfusion AMI is safe and effective method. 　　Key words：acute myocardial infarction；Emergency percutaneous coronary interventional therapy；Intravenous thrombolysis 　　急性心肌梗死的发生大多因冠状动脉粥样硬化斑块内皮损伤和功能失调，导致斑块破裂血栓形成，冠状动脉急性闭塞所致，尽早、充分、持续开通梗死相关血管再灌注，可以缩小梗死面积，减少并发症。近年来急性 ST 段抬