King S B
Department of Medicine and Radiology, Emory University Hospital, Atlanta, Georgia 30322.
Am J Cardiol. 1989 Jul 18;64(4):22B-24B. doi: 10.1016/s0002-9149(89)80005-0.
Whether thrombolytic therapy or immediate angioplasty should be the preferred treatment for patients with acute myocardial infarction has not yet been decided. Emergency angioplasty can be used as primary therapy, as an adjunct to thrombolytic therapy, or as a salvage procedure in patients in whom thrombolysis fails. Immediate angioplasty produces a higher recanalization rate, yet reclosure is more likely with this procedure. In many cases, patient selection for acute angioplasty remains controversial. Randomized trials comparing the results of thrombolysis with those of angioplasty are needed before definitive decisions can be made.
对于急性心肌梗死患者，溶栓治疗还是直接血管成形术应作为首选治疗方法尚未确定。紧急血管成形术可作为主要治疗方法、溶栓治疗的辅助手段，或用于溶栓失败患者的补救措施。直接血管成形术能产生更高的再通率，但该手术导致血管再次闭塞的可能性更大。在许多情况下，急性血管成形术的患者选择仍存在争议。在做出明确决定之前，需要进行比较溶栓与血管成形术结果的随机试验。
