急诊PCI和择期PCI治疗急性心肌梗死的效果比照观察

万伟 戴正东 徐高峰 蔡红专

【摘要】 目的：研究比较急诊经皮冠状动脉介入术（percutaneous coronary intervention，PCI）与择期PCI对急性心肌梗死的治疗效果。方法：选取2010年1月-2015年12月笔者所在医院收治的60例急性心肌梗死患者作为研究对象，随机将其分为两组，每组30例，急诊组、择期组分别采取急诊PCI、择期PCI治疗，比较两组临床疗效、TIMI血流情况、心血管事件发生率、住院时间及住院费用。结果：两组治疗总有效率比较差异无统计学意义（P>0.05），但急诊组治愈率为66.67%，高于择期组的40.00%，比较差异有统计学意义（P<0.05）；急诊组TIMI血流分级为3级的患者占比为70.00%，显著高于择期组的43.33%，比较差异有统计学意义（P<0.05）；急诊组心血管事件发生率为3.33%，明显低于择期组的20.00%，比较差异有统计学意义（P<0.05）；急诊组住院时间明显短于择期组，住院费用明显少于择期组，比较差异均有统计学意义（P<0.05）。结论：相比于择期PCI，对急性心肌梗死患者实施急诊PCI治疗安全有效。

【关键词】 急性心肌梗死； 经皮冠状动脉介入术； 急诊科

doi：10.14033/j.cnki.cfmr.2018.7.002 文献标识码 A 文章编号 1674-6805（2018）07-0004-02

【Abstract】 Objective：To compare and evaluate the efficacy of emergency percutaneous coronary intervention （percutaneous coronary intervention，PCI） and elective PCI in the treatment of acute myocardial infarction.Method：From January 2010 to December 2015，60 cases of acute myocardial infarction patients in our hospital were selected as the research object，patients were randomly divided into two groups，30 cases in each group. Emergency group and elective group were treated with emergency PCI and elective PCI respectively，the clinical effect，TIMI blood flow，incidence of cardiovascular events，hospitalization time and hospitalization expenses were compared between two groups.Result：The total effective rate between two groups showed no significant difference（P>0.05），but the cure rate in the emergency group was 66.67%，was higher than that of elective group（40.00%），the difference was statistically significant（P<0.05）.The proportion of TIMI grade 3 patients in the emergency department was 70.00%，was significantly higher than that of the elective group（43.33%），the difference was statistically significant（P<0.05）.The incidence of cardiovascular events in the emergency group was 3.33%，was significantly lower than that in the elective group（20.00%），the difference was statistically significant（P<0.05）.The hospitalization time in the emergency group was significantly shorter than the elective group，and the hospitalization expenses in the emergency group was significantly less than the elective group，the differences were statistically significant（P<0.05）.Conclusion：Compared with elective PCI，it is safe and effective to perform emergency PCI in acute myocardial infarction patients.

【Key words】 Acute myocardial infarction； Percutaneous coronary intervention； Emergency department

First-authors address：Macheng City Peoples Hospital，Macheng 438300，China

急性心肌梗死屬于较为常见的心血管疾病，其发病急骤，致死风险较高，经皮冠状动脉介入术（percutaneous coronary intervention，PCI）是急性心肌梗死的主要治疗方法[1]，但关于手术时机尚存在争议，本研究主要针对2010年1月-2015年12月笔者所在医院收治的60例急性心肌梗死患者进行研究，比较急诊PCI与择期PCI对急性心肌梗死的治疗效果。

1 资料与方法

1.1 一般资料

选取2010年1月-2015年12月笔者所在医院收治的60例急性心肌梗死患者作为研究对象，经冠脉造影检查明确为急性心肌梗死，均在发病后2 h内就诊，且在治疗前签署知情同意协议。本研究经医院伦理委员会批准。所有患者随机为两组，每组30例，其中，急性组男17例、女13例，年龄47～81岁，平均（62.85±15.37）岁；择期组男15例、女15例，年龄46～82岁，平均（62.93±15.49）岁。两组患者一般资料比较差异无统计学意义（P>0.05），具有可比性。

1.2 方法

急诊组、择期组分别采取急诊PCI、择期PCI治疗，其中，急诊组患者在入院后给予冠脉扩张、营养心肌等治疗，给予4 000 U/次低分子肝素皮下注射，2周后行PCI；择……