简介:摘要目的探讨经皮冠状动脉介入治疗(PCI)术对急性心肌梗死患者QT离散度(QTd)及校正QT离散度(QTcd)的影响。方法选择完成冠状动脉造影且成功地进行经皮冠状动脉介入治疗(PCI)患者114例为治疗组,并根据血管病变支数分为三个亚组单支病变组、双支病变组、多支病变组;临床确诊的急性心肌梗死患者未行PCI治疗40例为对照组。各组于术前及术后4h同步记录12导联心电图,分别计算QTd及QTcd。结果PCI术后4h与对照组相比,治疗组QTd及QTcd均有明显改善(均P<0.05);治疗组术前与术后4h相比,QTd及QTcd均有明显减小(均P<0.05);单支病变组、双支病变组、多支病变组之间QTd及QTcd差异有统计学意义(P<0.05)。结论PCI术后急性心肌梗死患者QTd及QTcd明显改善。
简介:BackgroundDuringprimarypercutaneouscoronaryintervention(PCI),manualthrombectomymayreducedistalembolizationandthusimprovemicrovascularperfusion.Smalltrialshavesuggestedthatthrombectomyimprovessurrogateandclinicaloutcomes,butalargertrialhasreportedconflictingresults.MethodsWerandomlyassigned10,732patientswithST-segmentelevationmyocardialinfarction(STEMI)undergoingprimaryPCItoastrategyofroutineupfrontmanualthrombectomyversusPCIalone.Theprimaryoutcomewasacompositeofdeathfromcardiovascularcauses,recurrentmyocardialinfarction,cardiogenicshock,orNewYorkHeartAssociation(NYHA)classIVheartfailurewithin180days.Thekeysafetyoutcomewasstrokewithin30days.ResultsTheprimaryoutcomeoccurredin347of5033patients(6.9%)inthethrombectomygroupversus351of5030patients(7.0%)inthePCI-alonegroup(hazardratiointhethrombectomygroup,0.99;95%confidenceinterval[CI],0.85to1.15;P=0.86).Theratesofcardiovasculardeath(3.1%withthrombectomyvs.3.5%withPCIalone;hazardratio,0.90;95%CI,0.73to1.12;P=0.34)andtheprimaryoutcomeplusstentthrombosisortarget-vesselrevascularization(9.9%vs.9.8%;hazardratio,1.00;95%CI,0.89to1.14;P=0.95)werealsosimilar.Strokewithin30daysoccurredin33patients(0.7%)inthethrombectomygroupversus16patients(0.3%)inthePCI-alonegroup(hazardratio,2.06;95%CI,1.13to3.75;P=0.02).ConclusionsInpatientswithSTEMIwhowereundergoingprimaryPCI,routinemanualthrombectomy,ascomparedwithPCIalone,didnotreducetheriskofcardiovasculardeath,recurrentmyocardialinfarction,cardiogenicshock,orNYHAclassIVheartfailurewithin180daysbutwasassociatedwithanincreasedrateofstrokewithin30days.
简介:Byanalyzingthethermalandburdenstructureconditionsinsidethemelter-gasifierofCOREXprocess,theadvantageanddisadvantageofPCIintothemelter-gasifierareclarified.TheinfluenceofPCIontherunningconditioninsidethefurnaceisanalyzedbasedontheinformationfromproductionoperationandmathematicalandphysicalsimulations,andmeasurestotacklewiththeproblemsarisingfromPCIareproposed.Themainresultsareasfollows.①Duetotheunfavorableconditionsforcokingofcoalinthemelter-gasifier,cokingofchargedlumpycoaltogetsemicokewithgoodsizeandstrengthcanhardlybeexpected.Tomaintainthepermeabilityoftheburdencolumn,apackedbedsimilartoblastfurnaceisnecessary.Therefore,alittlemorecokewithPCIinplaceofmostofthelumpycoalmayimprovetherunningofthereactor.Thiscanalsomakethelumpycoalselectioneasier.②Overallheatbalanceanalysisofthemelter-gasifiershowsthatPCIhasnoeffectonthethermalconditionofthefurnaceasawhole.Localheatbalanceanalysis,however,showsthattheheathofthemelter-gasifierisinacriticalstateoflowheatsupply.PCIintothehearthwilldeterioratethethermalcondition.ToavoidthecoolingofthehearthzonebyPCI,moreoxygencanbeblowntothehearthzone,i.e.increasetheoxygensupplytothehearthanddecreaseaccordinglytheoxygensupplytothefreeboard.Moreoxygensupplytothehearthseemstobringouttheissueofanincreaseinfuelrateand/ortherebythesmeltingintensity.DetailedanalysisofthephysicalchemicalprocessesconcludedthatPCIwithmorecorrespondingoxygensupplywillnotleadtotheincreaseoffuelrate.③Comparingwithblastfurnace,theracewayvolumeofCOREXmelter-gasifierisaboutonly1/10~1/5ofthatofcorresponding-sizeblastfurnace.ThissmallracewayisnotfavorableforPCI.ToenlargetheracewaytogetmorefavorableconditionforPCI,lesstuyereswithmoreoxygensupplyofeachtuyereisproposed.④Comparingwithlumpycoalfeedingintot
简介:摘要心血管疾病的急发催生了PCI术的兴起,而术后的养护国人了解的还不是很透彻,即使血管开通后患者仍有一些症状难以缓解,生活质量未能如愿提高。在养生调养方面,中医有着独特的优势,本文从5方面系统阐释PCI术后中医养生原则的应用,希望能给国人的术后调养带来一些帮助。
简介:摘要:通过对导弹弹上自驾仪进行分析和研究,并对被测对象测试需求特征进行综合分析,优化测试项目和测试资源配置,设计出自驾仪测试设备。该设备硬件采用基于PCI总线结构的工控机,软件采用Visual studio C++作为开发平台。
简介:摘要目的探讨急性冠脉综合征患者急诊绿色通道PCI术的应用情况。方法对我院急诊科1年零3个月以来救治的75例急性冠脉综合征患者的一般临床资料、病变冠脉、PCI术D2B时间的情况进行追踪分析。结果ACS患者的平均年龄64.85岁。ACS患者基础病的分布高血压41.3%,糖尿病14.7%,慢性肾衰8.0%,高尿酸血症8.0%。ACS患者行急诊PCI术的比例为68.0%,其平均D2B为151.74min。病变冠脉情况LCX占37.3%,RCA占49.0%,LAD占49.0%。单支病变占74.5%,三支病变占9.8%,双支病变占15.7%。结论ACS患者大部分均行PCI术治疗,其的D2B时间仍未达到新指南标准。冠脉病变以前降支及右冠的病变较为多见,且多以单支病变方式出现。
简介:摘要:目的 探讨血栓抽吸在急诊 PCI中的应用效果及护理要点。方法 选取 20例急诊 PCI中未应用血栓抽吸的 STEMI患者为对照组,再选取 20例急诊 PCI中应用血栓抽吸的 STEMI患者为观察组。比较 2组患者的 TIMI血流分级、无复流现象、 LVEF、住院期间及随访 6个月内心血管事件的发生率及住院时间。结果 观察组患者在 TIMI血流Ⅱ -Ⅲ、术后 1周复查心脏彩超的 LVEF、患者满意度高于对照组,无复流现象、住院期间及随访 6个月内心血管事件的发生率低于对照组,差异均有统计学意义( P< 0.05)。 2组患者术前心脏彩超的 LVEF、住院时间均无明显差异( P> 0.05)。结论 血栓负荷较重、支架内血栓的 STEMI患者在急诊 PCI中应用血栓抽吸能明显冠脉血流,减少无复流、急性冠状动脉闭塞等现象,改善患者预后,提高生活质量。同时应加强围术期的护理工作。