Abreu A, Patrício L, Bernardes L, Sousa L, Abreu J, Oliveira M, Quininha J, Ramos J M, Figueiredo L
Serviço de Cardiologia, Hospital de Santa Marta, Lisboa.
Rev Port Cardiol. 1995 Jan;14(1):29-41.
to evaluate the diagnostic and therapeutic role of emergency hemodynamic studies, in the coronary intensive care (UCI).
Retrospective study of--patients (P) submitted to emergency catheterization.
183 P (152 M and 31 F), mean age 56 +/- 11.5 years, admitted to UCI of Hospital Santa Marta and who had cardiac catheterization performed, between October 88 and November 92.
Patient clinical files were reviewed. We considered the reasons for emergency cardiac catheterization; final diagnosis; complications in the first 24 hours; catheterization role in the therapeutic orientation.
Reasons for hemodynamic study were: coronary artery disease (CAD) in 127 P (69%); aortic dissection in 33 P (18%); valvular disease in 19 P (10%) and other in 4 P (3%). Clinical diagnosis was confirmed in 92% and changed in 8% by hemodynamic study results. Left main coronary artery disease was diagnosed in 6.5% of CAD patients. Coronary artery disease was excluded in 5 P with previous CAD diagnosis, in 19 P with aortic dissection and in 11 valvular patients. 32% of P were sent to emergent surgery: 93% ascending aortic dissection and 20% of CAD, 76% of valvular disease. The hemodynamic study was decisive in the therapeutic option of myocardial revascularization in 77% of P with CAD: 39 emergent PTCA (31%), 13 primary (33%) and 14 P oriented to elective PTCA (11%); 26 emergent surgery and 19 P oriented to elective surgery (15%). The emergency cardiac catheterization mortality rate was 0.5%, and the morbidity 2.7%.
The contribution of Hemodynamic Department to UCI was decisive in the diagnostic and therapeutic orientation of critical patients.
评估急诊血流动力学研究在冠心病重症监护（UCI）中的诊断和治疗作用。
对接受急诊心导管插入术的患者（P）进行回顾性研究。
183例患者（P）（152例男性和31例女性），平均年龄56±11.5岁，于1988年10月至1992年11月间入住圣玛尔塔医院冠心病重症监护病房并接受了心导管插入术。
查阅患者临床档案。我们考虑了急诊心导管插入术的原因；最终诊断；最初24小时内的并发症；心导管插入术在治疗指导中的作用。
进行血流动力学研究的原因如下：127例患者（P）（69%）为冠状动脉疾病（CAD）；33例患者（P）（18%）为主动脉夹层；19例患者（P）（10%）为瓣膜病；4例患者（P）（3%）为其他疾病。血流动力学研究结果证实临床诊断的占92%，改变临床诊断的占8%。6.5%的CAD患者被诊断为左主干冠状动脉疾病。5例先前诊断为CAD的患者、19例主动脉夹层患者和11例瓣膜病患者经血流动力学研究排除了CAD。32%的患者被送去接受急诊手术：93%为升主动脉夹层患者，20%为CAD患者，76%为瓣膜病患者。血流动力学研究对77%的CAD患者的心肌血运重建治疗选择起决定性作用：39例进行急诊经皮冠状动脉腔内血管成形术（PTCA）（31%），13例进行初次PTCA（33%），14例患者被安排接受择期PTCA（11%）；26例进行急诊手术，19例患者被安排接受择期手术（15%）。急诊心导管插入术的死亡率为0.5%，发病率为2.7%。
血流动力学科对冠心病重症监护病房的贡献在危重症患者的诊断和治疗指导方面起决定性作用。
