冠状动脉完全闭塞病变的经皮腔内冠状动脉成形术  

Percutaneous transluminal coronary angioplasty in totally occluded coronary arteries

作　　者：霍勇[1] 朱国英[1] 高炜[1] 冯大力[1] 邢德智[1] 汪丽蕙[1] 

机构地区：[1]北京医科大学第一医院心内科

出　　处：《中华心血管病杂志》1994年第1期27-29,共3页Chinese Journal of Cardiology

摘　　要：我们自１９８７年１２月至１９９３年１０月对５５例５８支冠状动脉完全闭塞病变（ＴＯ）行经皮腔内冠状动脉成形术（ＰＴＣＡ），占同期ＰＴＣＡ总数的１８．２％。患者平均年龄５６．４±７．５岁，心绞痛患者１９例，心肌梗塞患者３６例，其中梗塞后１０小时内行急诊ＰＴＣＡ２例，１个月内和１个月以后行ＰＴＣＡ分别为６例和２８例。ＴＯ平均时间６８．４±４６．６天。完全闭塞和次全闭塞各占６５．５％和３４．５％。结果显示：病例成功率为８９．１％，病变成功率为８７．９％；完全闭塞成功率为８９．５％，次全闭塞成功率为８５．０％。闭塞类型、闭塞时间、闭塞长度等特征对成功率无显著性影响（Ｐ＞０．０５）；血管并发症率为１２．１％（７／５８），处理成功６处，死亡１例。Abstract From December 1987 to October 1993, percutaneous transluminal coronary angioplasty (PTCA) was performed in 55 patients with 58 total occlusions which accounted for 18.2% of the total cases of PTCA during the same period. The 55 cases were 56.4±7.5 years on average, 43 were males. 19 of them had angina pectoris, 36 had a history of myocardial infarction. Of the 36 cases, 2 cases had emergency PTCA within 10 hours after the onset of myocardial infarction, 6 cases went on PTCA within one month and 28 cases more than one month after onset. Time of total occlusion was estimated to an ayerage of 68.4±46.6 days. Of 58 total occlusions, LAD, LCX and RCA were 62.0%, 12.1% and 25.9% respectively, these lesions consisted of 38 completely total occlusions and 20 functionally total occlusions (subtotal occlusions). In this study, success rate of PTCA was 89.1% in cases and 87.9% in lesions, 89.5% for total occlusion and 85.0% for subtotal occlusion. Clinical characteristics and angiographic features, including previous history, type of occlusion, time of occlusion, and length of occlusion, etc, did not influence the success rate of PTCA significantly (P> 0.05). Acute vascular complications appeared in 7 lesions, 6 of them were redilated successfully and showed good results. 1 patient died 2 hours after LAD dilation due to an acute reocclusion. The success rate in PTCA of coronary total occlusions in this study is a high one.

关 键 词：动脉闭塞 病变 血管成形术 冠心病 

分 类 号：R654.2[医药卫生—外科学]