维持性血液透析患者冠心病介入治疗  

Percutaneous coronary intervention in uremic patients undergoing maintenance hemodialysis

作　　者：黄丽[1] 钱捷[1] 梁敏灵[1] 高皛磊[1] 沈文清[1] 梁波[1] 

机构地区：[1]广州医学院第三附属医院肾内科,广州510150

出　　处：《临床肾脏病杂志》2012年第2期70-71,共2页Journal Of Clinical Nephrology

摘　　要：目的探讨维持性血液透析患者合并冠心病心脏介入治疗的安全性和可行性。方法回顾性分析本院7例血液透析合并冠心病患者在强化透析的基础上应用非离子型低渗造影剂行冠状动脉造影术＋支架植入术的临床资料。结果单支病变3例，多支病变4例，行经皮腔内冠状动脉成形术（PTCA）置放支架1～2个。死亡3例，病情改善4例。此4例术后心绞痛症状改善，肾功能无进一步恶化。结论血液透析患者中合并不稳定心绞痛患者可考虑冠状动脉介入治疗，疗效较好，但对于同时有心肌酶谱升高者预后不良。Objective To evaluate the safety and possibility of coronary intervention in maintenance hemodialysis patients with coronary heart disease Methods Seven uremic patients were treated successfully with percutaneous trarnsluminal coronary angioplasty and stenting. In order to minimize the adverse effect on kidney due to contrast ,non-ionic and low osmular contrast medium was used. Further protection of the renal function was effected by more frequent dialysis and increasing fluid administration. Results Single-vessel lesion in 3 cases, multi-vessel lesion in 4 cases, one-two stents were placed. 3 deaths,4 cases improved. Condi- tion improved postoperative angina symptoms,no further deterioration of renal function. Conclusions Hemodialysis patients with unstable angina in patients with combined coronary intervention may be considered, treatment safety and improve prognosis Associated with elevated myocardial enzymes in patients with acute coronary syndrome with poor prognosis.

关 键 词：肾透析 冠状血管造影术 支架 

分 类 号：R459.5[医药卫生—治疗学]