非st段抬高急性冠状动脉综合征的急诊心肌血运重建术(文献综述)。

A B Nishonov, R S Tarasov
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引用次数: 0

摘要

目前关于非st段抬高急性冠状动脉综合征的治疗指南没有确定在这种情况下紧急冠状动脉旁路移植术的位置,但强调在高危患者中,应在最初24小时内进行血运重建。分析急诊冠状动脉旁路移植术的循证数据表明,非st段抬高急性冠状动脉综合征高危患者术前行主动脉内球囊反搏可改善临床预后。研究表明,在急性冠状动脉综合征患者的跳动心脏上进行冠脉搭桥可以改善手术血运重建的结果,如果能实现完全的血运重建,可能是这类患者的一种选择方法。我们还分析了比较冠状动脉旁路移植术和经皮介入治疗结果的研究,表明以牺牲持续效果为代价的冠状动脉搭桥术改善了长期预后并降低了未来重复血运重建的风险。
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[Emergency myocardial revascularization in non-ST-segment elevation acute coronary syndrome (literature review)].

Present-day guidelines on treatment of non-ST-segment elevation acute coronary syndrome do not determine the place of emergency coronary artery bypass grafting in this condition, however underlining that in high-risk patients, revascularization should be performed within the first 24 hours. Analysing the evidence-based data of using emergency coronary artery bypass grafting demonstrated that performing intra-aortic balloon counterpulsation prior to operation in high-risk patients with non-ST segment elevation acute coronary syndrome improved clinical outcomes. It was shown that CABG on the beating heart in patients with acute coronary syndrome improved outcomes of surgical revascularization and may be a method of choice in such patients, provided complete revascularization is achieved. We also analysed studies comparing the results of coronary artery bypass grafting and percutaneous interventions, demonstrating that CABG at the expense of a persistent effect improved the long-term prognosis and reduced the risk of repeat revascularizations in future.

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