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目的 分析急性冠状动脉综合征 (ACS)患者急诊经皮冠状动脉介入治疗 (PCI)术中无复流 (No Reflow)现象的原因、处理。方法 对 2 0 0 1- 0 6～ 2 0 0 3- 10经治的 72例ACS急诊PCI术中No -Reflow现象的冠状动脉的特点、可能原因、紧急处理及 1～ 2 8个月的结果进行分析。结果 1例术后 4h死于反复室颤 ,1例术后 76h死于心力衰竭 ,5例术中出现急性冠脉闭塞表现 ,经过冠状动脉内注射合心爽、硝酸甘油、IABP后好转 ,3例存活至今 ,1例术后 2 8个月死于脑干出血。结论 ACS患者急诊PCI术中出现No Reflow现象时 ,过程凶险 ,预后差 ,病死率高 ,治疗应首选联合应用冠状动脉内注射合心爽 (地尔硫 艹卓)、硝酸甘油或主动脉内球囊反搏 (IABP)。
Objective To analyze the causes and treatment of No Reflow in patients undergoing percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods The characteristics, possible causes, emergency management and results of 1 ~ 28 months of coronary artery in No -Reflow phenomenon of 72 cases of ACS underwent emergency PCI were studied in 2 0 0 1 0 6 0 2 0 0 3 0 10 Analyze. Results One patient died of recurrent ventricular fibrillation 4h after operation, one patient died of heart failure at 76h after operation, and acute coronary occlusion occurred in 5 patients. After intracoronary injection of Hyperactivity, nitroglycerin and IABP, A patient survived so far and one patient died of a brainstem hemorrhage 28 months after operation. Conclusions No Reflow phenomenon occurs during emergency PCI in ACS patients. The procedure is dangerous, the prognosis is poor, and the case fatality rate is high. Treatment should be the first choice of combination of intracoronary injection of Huanxin Shuang (Diltiazem), nitroglycerin or intra-aortic balloon Counterpulsation (IABP).