Leisch F, Hofmann R, Harringer W, Kerschner K
1. Medizinische Abteilung, Allgemeines Krankenhaus, Stadt Linz.
Wien Klin Wochenschr. 1991;103(22):678-83.
The present study reports on the complication rates in 143 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) within 4 weeks after thrombolysis for acute myocardial infarction. The results were analyzed with respect to the time between thrombolysis and PTCA. PTCA was successful in 130 patients (91%). The mortality was 0.7% (1 patient). Severe complications occurred in 9 further patients (7%): 8 reinfarctions (6%) and one patient with a large haematoma of the groin requiring surgical treatment (0.7%). The total complication rate, including milder was 24%. A comparison of patients treated with PTCA within the first 4 days after thrombolysis (group I, n = 67) with patients dilated between 5 and 28 days after thrombolysis (group II, n = 76) resulted in a complication rate of 33% in group I and 16% in group II (p less than 0.01). This important difference was due to the higher frequency of ischaemic complications in group I than in group II (28% versus 12%). Besides reinfarction (7.5% in group I versus 4% in group II), prolonged ischaemic episodes were the most frequent cause of complications. Our results demonstrate a very high risk of complications if PTCA is performed within the first 4 days after thrombolysis for acute myocardial infarction.
本研究报告了143例急性心肌梗死溶栓治疗后4周内行经皮腔内冠状动脉成形术（PTCA）患者的并发症发生率。根据溶栓与PTCA之间的时间对结果进行了分析。130例患者（91%）PTCA成功。死亡率为0.7%（1例患者）。另有9例患者（7%）发生严重并发症：8例再梗死（6%），1例腹股沟出现大血肿需手术治疗（0.7%）。包括较轻并发症在内的总并发症发生率为24%。将溶栓后前4天内行PTCA的患者（I组，n = 67）与溶栓后5至28天内行PTCA的患者（II组，n = 76）进行比较，I组并发症发生率为33%，II组为16%（p < 0.01）。这一显著差异是由于I组缺血性并发症的发生率高于II组（28%对12%）。除再梗死外（I组7.5%，II组4%），缺血发作时间延长是最常见的并发症原因。我们的结果表明，急性心肌梗死溶栓治疗后4天内行PTCA并发症风险非常高。
