药物侵入治疗是尼日利亚Stemi治疗的关键选择:综述

Emmanuel Auchi Edafe, Johnbull Jumbo
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摘要

初级经皮冠状动脉介入治疗(PCI)是st段抬高型心肌梗死(STEMI)患者推荐的再灌注方法,如果及时并由熟练的操作人员进行。然而,由于后勤问题和缺乏熟练的操作人员,该技术已被证明在没有PCI设施的地区存在局限性,并且在最初的医疗接触和气球之间等待时间较长。在STEMI患者中,在PCI前进行纤溶治疗有可能在最终PCI前进行早期药理学再灌注。根据目前的证据,辅助PCI没有优于主PCI的优势。药物侵入性再灌注的作用,定义为药物再灌注后常规延迟冠状动脉造影和PCI快速转移,在没有现场PCI能力的中心仍然可以考虑。 尼日利亚STEMI患者面临许多挑战,包括决策延迟、血运重建术费用、宗教信仰、心导管置入术的无知和可得性以及熟练的手术人员。为了满足尼日利亚心肌梗死的需求和挑战,我们需要一种有益、具有成本效益和挽救生命的治疗模式。因此,药物侵入是尼日利亚和其他撒哈拉以南非洲低收入国家的出路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmaco-Invasive Therapy is a Critical Option in Nigerian Stemi Treatment: A Review
Primary percutaneous coronary intervention (PCI) is the recommended reperfusion approach in patients with ST-segment elevation myocardial infarction (STEMI), When conducted in a timely and by skilled operators. This technique, however, has proven to have limitations in areas without PCI facilities and with long wait times between the initial medical contact and balloon because to logistical issues and a lack of skilled operators. In STEMI patients, pre-treatment with a fibrinolytic prior to PCI has the potential to give early pharmacologic reperfusion before definitive PCI. According to current evidence, assisted PCI has no advantage over main PCI. The role for pharmaco-invasive reperfusion, defined as pharmacological re-perfusion followed by rapid transfer for routine delayed coronary angiography and PCI may still be considered in centers without on-site PCI capability. Patients presenting with STEMI in Nigeria have a lot of challenges which include delay in decision making, cost of revascularization, religious believes, ignorance and availability of cardiac catheterization and the skillful personnel for the operation. To meet with the demand and challenges of Myocardial infarction in Nigeria, we need the mode of treatment that is beneficial, cost effective and lifesaving. Hence, pharmaco-invasive is the way for Nigeria and other low-income countries of sub-Saharan Africa.
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