边支血管球囊保护技术在冠状动脉分叉病变中的临床研究  

Clinical Investigation for Effects of Branch Balloon Protection Technology in Patients With Coronary Bifurcation Lesions

作　　者：孟晓雪[1] 白明[1] 张钲[1] 

机构地区：[1]兰州大学第一医院心内科,甘肃省兰州市730000

出　　处：《中国循环杂志》2016年第11期1056-1059,共4页Chinese Circulation Journal

摘　　要：目的 ：观察分叉病变边支血管直径〈2.5 mm的冠状动脉（冠脉）血管病变,主支血管置入支架的同时对边支血管进行预扩球囊保护边支血管技术的可行性及疗效。方法：选取2013-01至2014-08收住我院心内科治疗的82例冠心病患者,经冠脉造影证实罪犯血管直径狭窄〉70%的分叉病变,边支血管直径〈2.5 mm。其中40例为试验组,采用主支血管置入支架同时行边支血管预扩张球囊保护技术;42例为对照组,主支血管支架置入时采用钢丝保护技术。对两种术式即刻手术成功率、住院期间及术后9个月主要心血管事件（MACE）事件发生率进行比较。结果：试验组与对照组比较,经皮冠脉介入治疗（PCI）手术成功率显著升高（97.5% vs 92.9%,P〈0.05）;手术平均时间、对比剂用量、曝光时间明显减少（P〈0.05~0.01）;术中边支血管慢血流/无复流及冠脉血管受累发生率较低（2.5% vs 16.7%,P〈0.01）;术后9个月随访期间MACE的发生率降低（2.5% vs 7.1%,P〈0.05）;边支血管再狭窄率及晚期管腔丢失均较低[（0.37±0.23）mm vs （0.53±0.82）mm,P〈0.05]。结论 ：在分叉病变处理中,边支血管预扩球囊保护边支血管技术成功率高,在不影响主支血管置入支架的同时降低了边支血管闭塞和并发症的发生率,有利于应用于临床治疗。Objective： To observe the feasibility and efficacy of main branch percuteanous coronary intervention（PCI） with simultaneous branch balloon protection technology in patients with bifurcation branch vessel diameter2.5 mm.Methods： A total of 82 coronary artery disease（CAD） patients treated in our hospital from 2013-01 to 2014-08 were studied. All patients had coronary angiography confirmed bifurcation lesions, with the stenosis≥70% and the branch vessel diameter2.5 mm. The patients were divided into 2 groups： Experimental group, the patients received main branch PCI with simultaneous branch balloon protection technology, n=40 and Control group, the patients received main branch PCI with simultaneous steel wire protection technology, n=42. The immediate PCI success rate, hospital stay time and 9 months post-operative MACE occurrence rate were compared between 2 groups.Results： Compared with Control group, Experimental group showed the higher PCI success rate（97.5% vs 92.9%）, P0.05, less operation time, lower contrast dosage and X-ray exposure time, P0.05-0.01; lower occurrence rates of intra-operative slow flow/no reflow（2.5% vs 16.7%）, P0.01 and MACE; less branch vessel re-stenosis（0.37±0.23） mm vs（0.53±0.82） mm, P0.05.Conclusion： Branch balloon protection technology had the high success rate for treating the patients with coronary bifurcation lesions, it may reduce the occurrence rate of branch vessel occlusion and complications in clinical practice.

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[医药卫生—心血管疾病]