经桡动脉介入治疗冠脉慢性完全闭塞性病变82例临床研究  

Transradial coronary intervention of chronic total occlusion lesion 82 clinical research

作　　者：秦际德[1] 

机构地区：[1]河南省商丘市第一人民医院心内科,476000

出　　处：《中国临床实用医学》2010年第12期41-42,共2页China Clinical Practical Medicine

摘　　要：目的分析经皮冠状动脉介入治疗（PCI）对冠状动脉慢性完全闭塞性（CTO）病变安全性、临床效果，比较PCI与单纯药物治疗对冠状动脉慢性闭塞病变患者远期预后的影响。方法回顾2008年2月至2010年2月商丘市第一人民医院心内科住院患者82例，共116处CTO病变经桡动脉行介入治疗的资料。试验分组：PCI组：50例共67处病变经介入治疗开通闭塞血管；药物治疗组：32例共49处病变因未行PCI术或手术不成功而给予单纯药物治疗。分析两组的临床症状、主要并发症的发生率；两组均临床随访6个月，比较两组随访病例临床终点事件发生率；复查心脏彩超，观察患者心功能及室壁运动情况。结果116处CTO病变中67处病变经桡动脉成功开通，49处病变未能开通，成功率57．8％；两组临床特征差异无统计学意义。术后发生前臂血肿3例，无脉症0例，未见其他严重并发症。手术组不稳定心绞痛，再次心梗及死亡率均低于药物治疗组（P〈0．05），心脏彩超显示手术。结论经桡动脉行介入治疗可安全、可行地干预CTO病变，成功率高，无严重并发症，可改善长期预告慢性冠状动脉闭塞，提高其生活质量，降低死亡率。Objective To evaluate percutaneous coronary intervention （PCI）on coronary chronic total occlusion （CTO）lesions safety, clinical effectiveness, compared PCI and simple drug treatment of chronic coro- nary occlusion in patients with long - term prognosis. Methods From February 2008 to February 2010 Shangqiu City Department of Cardiology, First People＇ s Hospital, 82 cases of hospitalized patients, a total of 116 le- sions after radial artery CTO intervention information. Test group ： PCI group ： 50 cases of 67 lesions treated by interventional occlusion of blood vessels open. Drug treatment group：32 patients with 49 lesions due to surgery or surgery was not successful line of PCI given drug treatment alone. Analysis of the clinical symptoms of the two groups, the incidence of major complications ; two groups of clinical follow - up 6 months follow - up cases were compared clinical end point event rate; review echoeardiography and cardiac function and wall observed move- ment. Results 116 CTO lesions, 67 lesions after successful opening of the radial artery, 49 lesions could not open, the success rate of 57.8 %. The two groups no significant difference in clinical characteristics. Forearm, 3 cases of postoperative hematoma, no pulse disease 0, no other serious complications. Operation group with unstable angina, myocardial infarction and mortality were again lower than drug treatment group （ P 〈 0. 05 ） , echocardiography showed cardiac surgery group and wall motion was better than drug treatment group （P 〈 0. 05 ）. Conclusion The radial artery is safe and feasible intervention CTO lesions, a high success rate, no serious complications and chronic coronary occlusion may improve long - term prognosis of patients, improving quality of life and reduce mortality.

关 键 词：经挠动脉介入治疗 雷帕霉素涂层支架 慢性闭塞性病变 药物治疗 

分 类 号：R541.4[医药卫生—心血管疾病]