边支球囊潜埋技术与传统导丝保护治疗冠心病真性分叉病变的临床观察  

Clinical observation of the protection effects of side branch balloon submerged embedding technique and side branch guide wire protection technique during PCI for true coronary bifurcations

作　　者：程轶[1,2] 杨洋[1] 陈磊磊[1] 张定国[1] 王连生[1] 

机构地区：[1]南京医科大学第一附属医院心内科,江苏南京210029 [2]宿迁市第一人民医院心内科,江苏宿迁223800

出　　处：《南京医科大学学报（自然科学版）》2017年第1期81-84,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省高校"青蓝工程"科技创新团队带头人科研项目(苏教师[2012]39号);南京市科技局科技社会发展重点项目(2014SC517076)

摘　　要：目的:比较冠脉真性分叉病变在进行主支支架植入术时,边支球囊潜埋与边支导丝保护2种方法对边支的保护效果。方法:44例冠脉真分叉病变患者,随机分为球囊潜埋组(20例)和导丝保护组(24例)。比较两组边支开口受累及率、边支开口严重累及率、边支丢失率、导丝交换时间、完成导丝交换所接受X线暴露量及造影剂用量、术后血清高敏肌钙蛋白T(TNT-h)升高率、术后缺血性胸痛发生率。结果:两组边支开口受累及率、边支丢失率、术后缺血性胸痛发生率差异无统计学意义;两组边支开口严重累及率、导丝交换时间、X线暴露量、造影剂用量、术后血清TNT-h升高率差异有统计学意义(P<0.05);术后随访8~12个月,两组术后主要心血管不良事件的发生率差异无统计学意义。结论:在真性分叉病变介入治疗中,边支球囊潜埋技术较导丝保护技术可以明显减轻因斑块变形、移位造成的边支开口受累及的严重程度,保证交换导丝顺利,缩短手术时间,减少X线暴露量,减少造影剂用量,减少心肌损伤,且不增加术后主要心血管不良事件的发生率。Objective： To compare the protection effects between side branch balloon submerged embedding technique and side branch guide wire protection technique on the side branch in the process of main branch stent implantation during PCI for true coronary bifurcations. Methods： A total of 44 patients with true coronary bifurcations were randomly divided into two groups： group A and group B. Twenty cases in group A were treated with side branch balloon submerged embedding technique and the other 24 patients in group B were treated with side branch guide wire protection technique. Several parameters were compared, including the damage rate of the ostium of the side branch, the severe damage rate of the ostium of the side branch, the loss rate of the side branch, guide wire exchange time, the X-ray exposure amount, contrast agent dosage, the rising rates of postoperative TNT-h, and the rate of postoperative ischemic chest pain. Results： There were no statistic differences in the damage rate of the ostium of the side branch, the loss rate of the side branch, and the rate of postoperative ischemic chest pain （all P〉0.05）. The severe damage rate of the ostium of the side branch, guide wire exchange time, the X-ray exposure amount, contrast agent dosage, and the rising rate of postoperative TNT- h had statistical differences （all P〈0.05）. The incidence of major cardiovascular events （MACE） after 8 to 12 months follow-up had no significant difference（P〉0.05）. Conclusion： During PCI for true coronary bifurcations, the side branch balloon submerged embedding technique can reduce the severity of the ostium of the side branch damage, increase the successful rate of guide wire exchanging, shorten operation time, reduce X-ray exposure amount, contrast agent dosage and myocardial damage compared with the side branch guide wire protection technique after main branch stent implantation.

关 键 词：分叉病变 边支球囊潜埋 边支导丝保护 经皮冠状动脉介入术 冠状动脉造影检查 

分 类 号：R541.4[医药卫生—心血管疾病]