急性心肌梗死的溶栓和急診pci-英文ppt課件

1、1hrombolytic Therapy and PCI Southwest Hospital Southwest HospitalDept. of Cardiology, Southwest HospitalThe Thrid Military Medical UniversityChongqing Institute of Interventional Cardiology2 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI3 Southwest Hospital Southwest Ho

2、spital 4 Southwest Hospital Southwest Hospital 5 Southwest Hospital Southwest Hospital 6 Southwest Hospital Southwest Hospital 7 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI8 Southwest Hospital Southwest Hospital 9 Southwest Hospital Southwest Hospital 10 Southwest Hos

3、pital Southwest Hospital 11 Southwest Hospital Southwest Hospital 12 Southwest Hospital Southwest Hospital 13 Southwest Hospital Southwest Hospital 14 Southwest Hospital Southwest Hospital 15 Southwest Hospital Southwest Hospital 16 Southwest Hospital Southwest HospitalSTEMISTEMI的直接的直接PCI:PCI:影響近遠(yuǎn)期預(yù)

4、后的因素影響近遠(yuǎn)期預(yù)后的因素17 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI18 Southwest Hospital Southwest Hospital19 Southwest Hospital Southwest Hospital20 Southwest Hospital Southwest Hospital 21 Southwest Hospital Southwest Hospital 22 Southwest Hospital Southwest Hospital 23 So

5、uthwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI24 Southwest Hospital Southwest Hospital 25 Southwest Hospital Southwest Hospital 26 Southwest Hospital Southwest Hospital 27 Southwest Hospital Southwest Hospital 28 Southwest Hospital Southwest Hospital 29 Southwest Hospital

6、Southwest Hospital 30 Southwest Hospital Southwest Hospital 31 Southwest Hospital Southwest Hospital 32 Southwest Hospital Southwest Hospital 33 Southwest Hospital Southwest Hospital 34 Southwest Hospital Southwest Hospital35 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PC

7、I36 Southwest Hospital Southwest Hospital37 Southwest Hospital Southwest Hospital 38 Southwest Hospital Southwest Hospital 39 Southwest Hospital Southwest Hospital 40 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI41 Southwest Hospital Southwest Hospital 42 Southwest Hosp

8、ital Southwest Hospital 43 Southwest Hospital Southwest Hospital 44 Southwest Hospital Southwest Hospital Immediate transfer for PCI did not improve the primary outcome significantly, but reduced the rate of death, reinfarction,or stroke at 12 months in patients with STEMI, treated with thrombolysis

9、 and clopidogrel in areas with longtransfer distances. (Norwegian Study on District Treatment of ST-Elevation Myocardial Infarction.J Am Coll Cardiol 2010;55:1021045 Southwest Hospital Southwest Hospital Lancet 2004; 364: 10455346 Southwest Hospital Southwest Hospital 47 Southwest Hospital Southwest

10、 Hospital 48 Southwest Hospital Southwest Hospital ConclusionsIn patients with STEMI, early post-thrombolysis catheterisation and appropriate intervention is safeand might be preferable to a conservative strategy since it reduces the need for unplanned in-hospitalrevascularisation, and improves 1-ye

11、ar clinical outcome.49 Southwest Hospital Southwest Hospital 50 Southwest Hospital Southwest Hospital 51 Southwest Hospital Southwest Hospital 52 Southwest Hospital Southwest Hospital 53 Southwest Hospital Southwest Hospital Conclusions Early elective PCI within 48 hours of successfulthrombolytic th

12、erapy for AMI appeared safe and more beneficial compared with PCIperformed later. Am J Cardiol 2009;103:1333133854 Southwest Hospital Southwest Hospital 55 Southwest Hospital Southwest Hospital 56 Southwest Hospital Southwest Hospital 57 Southwest Hospital Southwest Hospital ConclusionsThe mortality

13、 benefit of immediate referral to PCI after pharmacological treatment for STEMIderives from a reduction in the time to reperfusion of patients with failed thrombolysis in need of rescue PCI.In patients with evidence of successful reperfusion, “elective” PCI within 3 days may be sufficient to reduce

14、the recurrent ischemic events.58 Southwest Hospital Southwest Hospital 59 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8. Facilitated PCI60 Southwest Hospital Southwest Hospital 61 Southwest Hospital Southwest Hospital 62 Southwest Hospital Southwest Hospital 63 Southwest Hospital Southw

15、est Hospital 64 Southwest Hospital Southwest Hospital 65 Southwest Hospital Southwest Hospital 66 Southwest Hospital Southwest Hospital 67 Southwest Hospital Southwest Hospital PCI vs Fibrinolysis8.Facilitated PCI68 Southwest Hospital Southwest Hospital69 Southwest Hospital Southwest Hospital70 Sout

16、hwest Hospital Southwest Hospital Lancet 2006; 367: 5697871 Southwest Hospital Southwest Hospital 72 Southwest Hospital Southwest Hospital 73 Southwest Hospital Southwest Hospital 74 Southwest Hospital Southwest Hospital 75 Southwest Hospital Southwest Hospital76 Southwest Hospital Southwest Hospital77 Southwest Hospi