两种指引导丝操作技术治疗冠状动脉慢性闭塞性病变患者的疗效及安全性  

Therapeutic efficacy and safety of percutaneous coronary intervention by only the guidewire versus by the guidewire dependent on balloon for treatment of chronic total occlusions

作　　者：郭炜华[1] 王国宏[1] 吴明营[1] 陈波[1] 王雷[1] 刘君[1] 马志敏[1] 陈喆[1] 

机构地区：[1]首都医科大学附属北京同仁医院心脏中心,100176

出　　处：《中华老年医学杂志》2011年第7期544-546,共3页Chinese Journal of Geriatrics

摘　　要：目的观察应用以球囊做支撑用普通指引导丝（中等硬度3～6g）（球囊支撑组）及单独使用指引导丝（普通组）治疗冠状动脉（冠脉）慢性闭塞性病变（CTO）的可行性、安全性和效果。方法经冠脉造影检查发现有CTO病变并行经皮冠脉介入（PCI）治疗的患者108例（陈旧性心肌梗死59例，不稳定型心绞痛22例，稳定型心绞痛27例）。普组组65例，球囊支撑组43例，比较两组患者手术成功率、并发症发生率等。结果108例CTO病变88例（81．5％）获得成功，20例（18．5％）未成功，普通组与球囊支撑组分别成功52例（80．0％）与36例（83．7％），两组比较差异无统计学意义（P〉O．05）。并发症普通组7例（10．8％）高于球囊支撑组的1例（2．3％）（P＜0．05）。术中无死亡病例，术后住院期间无主要不良心脏事件（MACE）发生。结论以球囊支撑普通指引导丝做CTO安全方便。Objective To observe the feasibility, safety and efficacy of percutaneous coronary intervention （PCI） for treatment of chronic total occlusions （CTO）by only the guidewire versus by the guidewire dependent on balloon. Methods The 108 patients with CTO con{irmed by coronary angiography and treated with PCI from March 2009 to March 2011 were enrolled in this study, including 59 cases with old myocardial infarction, 22 unstable angina cases and 27 stable angina cases. The clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac events （MACEs） during follow-up were retrospectively analyzed between group A （only by the guide wire） and group B （by guide wire dependent on balloon）. Results The 88 of 108 patients （81.5%） got successful operations. The success rate of CTO was a little higher in group B than in group A （80.0%（52/65） vs. 83.7^（36/43）, P〉0.05）. The rate of total complications was more in groupA than in group B （10. 80%（7/65） vs. 2.3%（1/43）, P〈0.05]. No death occurred during operation, no MACE occurred after operation in hospital and no patients underwent emergency coronary artery bypass graft （CABG） in the two groups. Conclusions The PCI for treatment of CTO used by the guidewire dependent on balloon shows a safety and effecary.

关 键 词：冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]