分期介入治疗颈动脉狭窄合并冠心病患者的疗效及随访效果观察  

Effect and follow-up effect of staged interventional therapy in treatment of carotid artery stenosis patients with coronary artery disease

作　　者：孙雨华[1] 耿晓坤[2] 张正海[1] 张海滨[1] 甘舜进[1] 张立新[1] 

机构地区：[1]首都医科大学附属北京潞河医院心内科,101149 [2]首都医科大学附属北京潞河医院神经内科,101149

出　　处：《检验医学与临床》2017年第9期1257-1259,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨分期介入治疗颈动脉狭窄合并冠心病患者的及随访效果。方法选取2008年10月至2012年10月期间在该院就诊的78例颈动脉狭窄合并冠心病患者,随机分为观察组和对照组,每组39例,两组患者均行经皮冠状动脉介入治疗(PCI)和颈动脉支架术(CAS),观察组患者行分期介入治疗,对照组患者行同期介入治疗。对比观察两组患者的治疗效果、并发症以及随访效果。结果观察组患者的临床治疗总有效率为97.4%,对照组患者的临床总有效率为79.5%,两组间差异有统计学意义(P<0.05);观察组患者在治疗过程中的并发症发生率10.3%,对照组患者的并发症发生率为38.5%,差异有统计学意义(P<0.05);手术后进行长期随访发现,观察组患者支架内狭窄、血管闭塞、心肌梗死以及脑梗死的发生率情况均显著低于对照组,差异有统计学意义(P<0.05)。两组患者的肾功能术前术后比较差异均无统计学意义(P>0.05),且组间比较术前术后差异也无统计学意义(P>0.05)。结论对于颈动脉狭窄合并冠心病患者,分期先行PCI术后再行CAS术治疗不仅疗效显著,并发症发生率低,且同时长期随访效果好,安全可靠,是临床上一种安全有效的治疗方式。Objective To investigate the effect and follow-up effect of staged interventional therapy in treatment of carotid artery stenosis patients with coronary artery disease.Methods A total of 78 patients with carotid artery stenosis and coronary artery disease were treated in the hospital from October 2008 to October 2012 were selected.The patients were randomly divided into observation group and control group,with 39 cases in each group.All patients were given carotid artery stenting （CAS） and percutaneous coronary intervention （PCI）,patients in control group were given simultaneous hybrid interventional therapy,while the patients in observation group were given staged interventional therapy.The therapeutic effects,the rates of complications and follow-up effect were compared between the two groups.Results After operation,the total effective rate of observation group was 97.4%,which of the control group was 79.5%,and the difference was statistically significant between the two groups（P〈0.05）.The incidence of complications of the control group was 38.5%,which of the observation group was 10.3%,and the difference was statistically significant between the two groups （P〈0.05）.After long-term follow-up,the incidences of in-stent stenosis,vascular occlusion,myocardial infarction and the probability in observation group were all significantly lower than the control group （P〈0.05）.The differences of kidney function of two groups had no statistical significance before and after surgery （P〉0.05）,and the differences between the two groups were not statistically significant （P〉0.05）.Conclusion Using staged interventional therapy in treatment of patients with carotid artery stenosis and coronary artery disease could improve the efficacy,as well as reduce the incidences of complications and improve follow-up effect.It is a safe and clinically effective treatment.

关 键 词：分期介入治疗 颈动脉狭窄 冠心病 疗效 

分 类 号：R654.2[医药卫生—外科学]