摘要
目的分析急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)院内死亡原因。方法连续入选自首都医科大学附属北京潞河医院心内科2010年1月至2013年12月因STEMI行直接PCI院内死亡患者资料,回顾性分析其死亡原因。结果总计1314例STEMI患者进行直接PCI治疗,住院期间死亡44例,病死率3.3%;发病到就诊平均时间(5.3±4.6)h;43.8%的患者梗死相关血管为前降支,其中11例行经皮冠状动脉腔内成形术(PTCA),33例患者植入支架44枚,平均每例患者植入支架(1.1±0.8)枚。主要死亡原因为心源性休克56.8%,其次为心脏破裂占20.5%,15.9%死于血管并发症(包括无复流、支架内血栓、冠状动脉穿孔、夹层)。结论 STEMI患者直接PCI院内死亡原因依次为心源性休克、心脏破裂、血管并发症。
Objective To analyze the causes of in-hospital death during direct percutaneous coronary intervention （PCI） in patients with ST-segment elevation myocardial infarction （STEMI）. Methods The data were collected from died STEMI patients during PCI from Jan. 2010 to Dec. 2013, and the death causes were retrospectively analyzed. Results There were totally 1314 STEMI patients undergone PCI, among them 44 died during hospitalization and mortality was 3.3%, and average onset-to-hospital time was （5.3 ±4.6） h. There were 43.8% cases with anterior descending infarction, among them 11 undergone percutaneous transluminal coronary angioplasty. There were 33 cases undergone implantation of 44 stents and average （1.1 ± 0.8） stents implanted in one case. The primary death causes were cardiogenic shock （56.8%）, cardiac rupture （20.5%） and vascular complications （15.9%, including non-reflow, stent thrombosis, and coronary artery perforation and dissection）. Conclusion The causes of in-hospital death during direct PCI are cardiogenic shock, cardiac rupture and vascular complications in STEMI patients.
出处
《中国循证心血管医学杂志》
2015年第1期125-127,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
