经皮冠脉介入手术时机的选择对急性心肌梗死患者左室重构及心功能的影响

目的:探讨手术时机的选择对急性心肌梗死患者行经皮冠脉介入手术后左室重构及心功能的影响。方法:选择2014年10月-2015年10月在我院接受经皮冠脉介入手术治疗的97例急性心肌梗死患者为研究对象,根据手术时间不同将患者分为急诊手术组(49例)和择期手术组(48例)。观察并比较两组患者手术前后平均二尖瓣压力差(mMPG)、肺动脉平均压(mPAP)、左室舒张末径(LVDEd)、左室收缩末径(LVSEd)、左房内径(LAd)以及半年内心衰再住院率。结果:手术前,两组患者心功能及血流动力学各指标比较,差异均无统计学意义(P0.05);手术后,两组患者LVDEd,LVSEd及LAd均低于手术前,且急诊手术组患者LVDEd,LVSEd及LAd均低于择期手术组,差异具有统计学意义(P0.05);手术后,两组患者mMPG及mPAP均低于手术前,且急诊手术组患者mMPG及mPAP均低于择期手术组,差异具有统计学意义(P0.05);急诊手术组患者术后6个月心衰再住院率(2.04%)低于择期手术组(6.25%),差异具有统计学意义(P0.05)。结论:手术时机的选择对于行经皮冠脉介入手术的急性心肌梗死患者具有重要意义。与择期手术效果相比,急诊手术能够更好地改善患者的心功能及左室重构,减少心衰再住院率,值得在临床推广应用。

Effects of Operation Opportunity on Left Ventricular Remodeling and Heart Function of Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention

Objective:To investigate the effect of the timing of surgery on left ventricular remodeling and cardiac function after percutaneous coronary intervention in patients with acute myocardial infarction.Methods:97 cases with acute myocardial infarction who had taken the percutaneous coronary interventional surgery in our hospital from October 2014 to October 2015 were selected as the research objects, and according to the different operation time, the patients were divided into the emergency surgery group (49 cases) and the selective surgery group (48 cases). Then the LVDEd, LVSEd, LAd, mMPG and mPAP of patients in the two groups before and after the operation were observed and compared.Results:There was no statistically significant difference about the hemodynamics and heart functions of patients in the two groups before the operation (P>0.05); After the operation, the LVDEd, LVSEd and LAd in the two groups decreased, and the emergency surgery group was lower than that of the selective surgery group, and the difference was statistically significant (P<0.05); After the operation, the mMPG and mPAP in the two groups decreased, and the emergency surgery group was lower than that of the selective surgery group, and the difference was statistically significant (P<0.05); The six-months'' readmission rate of the emergency surgery group was 2.04%, which was lower than 6.25% in the selective surgery group, and the difference was statistically significant (P<0.05).Conclusion:The operation opportunity of percutaneous coronary intervention for patients with acute myocardial infarction is very important. Compared with the selective surgery, the emergency surgery can improve the cardiac function and left ventricular remodeling, reduce the rate of readmission, and it is worthy of clinical application.