Gott J P, Han D C
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Semin Thorac Cardiovasc Surg. 1995 Oct;7(4):198-207.
Most clinicians have become convinced of the fundamental role of an early reperfusion strategy in the improved outcome for patients suffering acute myocardial infarction. An increasing body of work suggests that the surgeon has the best opportunity for control of the conditions of acute reperfusion, attenuation of secondary injury, and provision of superior myocardial salvage compared with thrombolytic or angioplasty therapy. Before general acceptance or implementation of surgical treatment as an initial treatment for certain acute infarct patient subgroups, the policy must be compared with our current standards of care in a prospective, randomized fashion. The available data suggest that such inclusion of a primary surgical option in trials investigating treatment of acute myocardial infarct is long overdue.
大多数临床医生已确信早期再灌注策略在改善急性心肌梗死患者预后方面的重要作用。越来越多的研究表明，与溶栓或血管成形术治疗相比，外科医生在控制急性再灌注条件、减轻继发性损伤以及提供更好的心肌挽救方面具有最佳机会。在将手术治疗作为某些急性梗死患者亚组的初始治疗方法被广泛接受或实施之前，必须以前瞻性、随机的方式将该策略与我们当前的护理标准进行比较。现有数据表明，在研究急性心肌梗死治疗的试验中纳入主要手术选择早就应该进行了。
