检索历史 清除

目的 探讨如何提高经桡动脉途径行直接冠状动脉介入术(primary percutaneus coronary intervention,PCI)治疗急性心肌梗死的成功率.方法 回顾性分析本院2005年3月至2008年1月经桡动脉途径行直接PCI的急性心肌梗死的患者152例,记录患者临床特征,病变特点,PCI操作结果,随访情况.结果 临床抢救成功率为98.1%,桡动脉穿刺成功率为100%,冠脉造影成功率为100%,直接PCI成功率为100%,罪犯血管为前降支占30.8%,回旋支3.9%,右冠为65.3%,door-to-ballon时间平均(45.3±11.3)min,支架植入数平均1.2±0.2,术后第2周查心脏彩超LVEF平均为64.5%.结论 合理选择病例,提高经桡动脉途径行PCI的技术,加强抗凝,抗栓,注意术中监护,配合术后护理,有助于提高经桡动脉行直接介入治疗急性心肌梗死的抢救成功率,降低并发症发生率,降低死亡率.

Objective The purpose of this study was to evaluate how to reduce the mortality of primary percutaneous coronary intervention(PCI) for acute myocardial infarction(AMI) via radial artery.MethodsWe retrospectively analyzed the data of 152 AMI patients who arrived within 12 hours of pain between March 2005 and June 2007 ,The transradial approach was used in these patients with hemodynamicaUy stable and palpable right radial pulse.ResultsAngiographic success rate was 100% ,rate of Primary coronary stenting was 88.5% ,doorto-ballon time(from patient arrival at the catheterization room to the time of ballon expanded) was 45.3 ±11.3min,infarction related artery was left anterior descending coronary artery 30.8%,left circumflex coronary artery 3.9%,right coronary artery 65.3%,left ventricular ejection fraction which measured two weeks after primary PCI was 64.5% ,mortality rate was 1.9% ,no major vascular complications occur.ConclusionTo selected patients,increasing experience of transradial coronary intervention,enhance anticoagulation,and with appropriate postoperative care should be heipful for reducing the mortality in patients with acute myocardial infarction treated by primary coronary stenting via the transradial approach.