激光血运重建术治疗冠心病的临床研究  

CLINICAL STUDY OF TRANSMYOCARDIAL LASER REVASCULARIZATION TREATING CORONARY ARTERY DISEASE

作　　者：赵根尚 法宪恩 

机构地区：河南医科大学第二附属医院心外科,河南郑州

出　　处：《医师进修杂志》2000年第12期17-18,共2页Journal of Postgraduates of Medicine

摘　　要：目的：总结分析激光血运重建术治疗冠心病的临床经验，资料及方法：收治３例冠心病患者均为不稳定性心绞痛，有陈旧性心肌梗死１例，３例均合并Ⅱ期高血压病，超场所主动图左室射血分数为０．５７～０．６２，ＦＳ０．２８～０．３０。经心肌核素扫描（＾９９ｍＴｃ－ＭｉＢｉ）及心电图检查均提示前壁及下壁缺血。在全麻下经左胸前外侧第５肋间进胸，显露左心室壁，采用高功率二氧化碳激光打孔器（梅曼公司ＨＬ－１００型）在左室缺血区域打孔８～１４个。结果：３例病人术２周全部康复出院，术后无心律失常，无心衰及心肌梗死，术后心绞痛症状均全部缓解，一般体力活动不受限制。结论：激光血运重建术治疗冠心病是安全、有效的，对于国人由于冠状动脉血管纤细，激光血运重建术适应症可适当放宽。Objective:To review the clinical experience of sole transmyocardial laser revascularization (TMLR) in treatment of coronary heart disease (CHD).Material and Methods:Three cases were all unstable angina,age was between 45～64 yearsold.Past medical history included 100% hypertension,prior AMI 33.3%.Left ventricular ejection fraction was between 0.57～0.62,FS 0.28～0.30,ECG and SPECT ( 99m Tc-MiBi) showed anterior and inferior wall ischemia.TMLR was performed on the beating heart via a left anterolaterial thoracotomy in the fifth intercoseal space.CO 2 laser mashine (Meiman HL-100) was used.Transmyocardial penetration number was between 8～14 in ischemic zone.Results:The perioperative mortality was.There was not post-operative complication,such as AMI,left ventricular failure.Angina were all not existence.Mean recovery time was two weeks.Conclusion:Sole TMLR is a safe and effective procedure for treatment of end stage CHD especially for not amenable to PTCA or CABG.The indication for TMLR should be extended in our country.

关 键 词：激光血运重建术 冠心病 心绞痛 外科手术 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]