双指引导管技术治疗严重冠状动脉穿孔的疗效及安全性  

The outcome and safety of treatment for severe coronary perforations with dual catheter technique

作　　者：戴士鹏 张建刚[2] 王炳勋[2] 刘永兴[2] 徐泽升[1,2] 

机构地区：[1]天津医科大学,天津300070 [2]沧州市中心医院

出　　处：《临床心血管病杂志》2018年第2期120-123,共4页Journal of Clinical Cardiology

摘　　要：目的:评价双指引导管技术治疗严重冠状动脉穿孔(EllisⅢ型)对患者预后的影响及应用的安全性。方法:回顾分析从2010-06-2017-06期间所有于我院行经皮冠状动脉介入治疗过程中发生EllisⅢ型冠状动脉穿孔36例患者的临床及影像资料,同时对应用双指引导管技术治疗(双指引导管组,17例)与应用传统单指引导管技术治疗(单指引导管组,19例)2组患者的基线情况、引起穿孔的器械、穿孔的治疗及患者的预后进行比较。结果:在研究期间总共完成21 384例经皮冠状动脉介入治疗,其中36例发生EllisⅢ型冠状动脉穿孔,发生率为0.16%。双指引导管组、单指引导管组分别有3例、10例发生心包压塞,2组比较差异有统计学意义(P<0.05)。双指引导管组未发生与应用第2根指引导管相关的冠状动脉及外周血管并发症。结论:应用双指引导管技术可显著减少EllisⅢ型冠状动脉穿孔患者心包压塞的发生,在有经验的术者操作下应用安全。Objective：To evaluate the outcome and safety of patients with severe coronary perforations（EllisⅢ）who were treated with the dual catheter technique.Method：We retrospectively reviewed all patients＇ clinical and imagery data between June 2010 and June 2017 who underwent PCI in our department for the occurrence of severe coronary perforations,and compared baseline characteristics,perforation etiology,treatment and outcomes of patients treated with the dual versus the traditional single guiding catheter approach.Result：The total of 21384 percutaneous coronary interventions were performed in our department and there were 36 documented severe coronary artery perforations（EllisⅢ）patients during that period of time（0.16%）.17 patients were treated with a dual catheter technique.Whereas the other 19 patients were treated using a single guiding catheter.3 patients and 10 patients happened cardiac tamponade respectively in dual and single catheter group（P0.05）.No coronary or peripheral vascular access complications occurred due to the use of a second guiding catheter.Conclusion：The dual catheter technique can significantly decrease the occurrence of cardiac tamponade.It was safe in experienced operator.

关 键 词：冠状动脉疾病 心脏导管插入术 冠状动脉穿孔 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]