逆向精确溶栓联合支架植入术治疗急性冠状动脉闭塞病变1例

摘要

Reperfusion therapy for acute myocardial infarction has the best opportunity to save patient’s life, reduce the early mortality and to improve patient’s life quality. The effective methods used to reintroduce blood flow to an ischemic region of the myocardium currently include intravenous thrombolysis, intracoronary thrombolysis, thrombectomy and intervention which directly catheterizes the infarct-related artery. Up to now, there is no report about reverse thrombolysis for acute coronary artery occlusion. In this paper, we reported a case with satisfactory result, who received reverse precise thrombolysis with urokinase along with stenting. Several critical issues need further investigation, including specific definition criteria of the target vessel thrombosis, standardized manipulation methods, as well as its long-term efficacy.%　　急性心肌梗死的再灌注治疗是挽救患者生命、降低早期死亡率及提高患者生活质量的最重要方法。目前，实现缺血心肌再灌注的有效方法主要有静脉溶栓、冠状动脉内溶栓、血栓抽吸及通过介入方法直接开通梗塞相关动脉等。但冠状动脉闭塞病变施行逆向溶栓的方法国内外尚无报道。本文报告1例运用尿激酶经微导管行冠状动脉逆向溶栓联合支架植入开通阻塞动脉，最终效果良好。但靶血管血栓性病变如何界定、具体标准操作方法及对远期疗效观察等方面的问题，仍有待进一步研究明确。