切割球囊在介入治疗中对冠状动脉分支血管保护作用的研究  

Protective effects of cutting balloon on coronary artery branching during interventional therapy

作　　者：张华巍[1] 陈韵岱[1] 孙志军[1] 王锦达[1] 陈思[1] 李传威[1] 刘继轩 张建[1] 吕侣[1] ZHANG Hua-wei;CHEN Yun-dai;SUN Zhi-jun;WANG Jin-da;CHEN Si;LI Chuan-wei;LIU Ji-xuan;ZHANG Jian;LV Lv(Departments of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China)

机构地区：[1]中国人民解放军总医院心血管内科,北京100853

出　　处：《中国循证心血管医学杂志》2017年第3期297-300,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的对比弥漫性病变介入治疗过程中,在应用普通球囊扩张的基础上应用切割球囊是否对分支血管增加了保护作用。方法入选2014年1月~2015年12月间于中国人民解放军总医院心血管内科200例冠状动脉粥样硬化性心脏病(冠心病)患者,通过计算机随机软件随机分为两组,一组在普通球囊基础上加用切割球囊100例,另一组单纯应用普通球囊预扩张100例,术后即刻观察手术成功率(残余狭窄小于10%)、分支受累情况、手术引起的外周血管并发症及围手术期心血管MACE事件情况(复发心绞痛、急性心肌梗死、心律失常、心力衰竭、冠心病死亡)。结果切割球囊组患者100例,普通球囊组患者100例,两组患者在性别构成,年龄,危险因素,心功能,既往病史几个方面进行比较,差异无统计学意义。切割球囊组与普通球囊组在即刻造影结果上相比对分支影响明显降低(P=0.005),围手术期并发症上也低于普通球囊组(P=0.032)。结论对于弥漫性病变治疗过程中,应用切割球囊行预扩张及血管成形术对比普通球囊减少了分支的闭塞率,并发症较少,是临床实践中治疗冠状动脉弥漫性病变安全、有效、可行的方法。Objective To evaluation the protective effects of cutting balloon on the basis of the application of common balloon dilatation in the process of interventional treatment of diffuse lesions. Methods A total of 200 patients with coronary heart disease were randomly divided into two groups at the PLA General Hospital from January 2014 to December 2015. One group (n=100) was treated with cutting balloon on the basis of an ordinary balloon and the other group (n=100) was treated with an ordinary balloon Pre-expansion. The operative success rate (residual stenosis less than 10%), branch involvement, surgical peripheral vascular complications and perioperative cardiovascular MACE events (recurrent angina pectoris, acute myocardial infarction, arrhythmia, heart failure,crown Heart disease death) were measured after operation. Results There were no significant differences in gender composition, age, risk factors, cardiac function and previous medical history in the two groups. Compared with the conventional balloon group, the effect of arteriography result on the branching was significantly lower (P=0.005), and surgical complication rate were also lower in the cutting balloon group (P=0.032). Conclusion For the treatment of diffuse lesions, the use of cut balloon pre-expansion and angioplasty can reduce the branch of the occlusion rate, with fewer complications. It is a safe, effective and feasible method for the treatment of coronary artery diffuse lesions in clinical practice.

关 键 词：经皮冠状动脉介入 切割球囊 切割球囊成形术 

分 类 号：R816.2[医药卫生—放射医学]