【摘要】 目的分析总结经冠脉造影证实的右优势型右冠脉急性闭塞导致急性下壁心肌梗死的患者行直接经皮冠状动脉介入(PPC)I治疗手术时低血压状态的原因及对策。方法选择112例经冠脉造影证实的右优势型右冠脉急性闭塞导致急性下壁心肌梗死的患者,当患者在PPCI治疗术中开通冠脉病变血管时出现低血压状态时,先给予静脉快速补充生理盐水治疗,若血压不能恢复正常,再酌情使用阿托品、多巴胺及临时起搏治疗。结果全组有103例病例在PPCI手术中出现低血压状态,有59例通过单纯静脉快速补充生理盐水治疗后得以纠正。结论在右优势型右冠脉急性闭塞导致急性下壁心肌梗死的患者进行PPCI手术出现低血压状态时,可以先尝试使用静脉快速补充生理盐水的治疗方法来纠正。更多还原

【Abstract】 Objective To summarize the cause and strategy of hypotension in patients underwent primary percutaneous coronary intervention(PPCI) with acute inferior wall myocardial infarction,they demonstrated right dominant type of right coronary artery and acute right coronary occlusion by coronary angiography.Methods 112 patients underwent primary percutaneous coronary intervention with acute inferior wall myocardial infarction,they demonstrated right dominant type of right coronary artery and acute right coronary occlusion by coronary angiography.They appeared with hypotension when patency of infarct-related right coronary artery by PPCI,whose therapy with the sequential algorithm as physiological saline quickly intravenous infusion at first,if blood pressure not improved,then used atropine,dopamine and temporary cardiac pacing.Results 103 patients appeared with hypotension when they underwent PPCI,59 patients retrieved by physiological saline quickly infusion.Conclusion Patients underwent primary percutaneous coronary intervention with acute inferior wall myocardial infarction with right dominant type of right coronary artery and acute right coronary occlusion,when they appeared with hypotension,we can attempt to retrieve by physiological saline quickly infusion.更多还原