不同方法行单支架处理右冠状动脉后三叉病变的临床分析  

Clinical analysis of treatment of trigeminal lesions after right coronary artery with single stent by different methods

作　　者：苏永才[1] 张小乐[1] 黄志锋[1] 冯新武[1] Su Yongcai;Zhang Xiaole;Huang Zhifeng;Feng Xinwu(Department of Cardiology, the First People's Hospital of Zhaoqing, Zhaoqing 526021, China)

机构地区：[1]肇庆市第一人民医院心内科,广东肇庆526021

出　　处：《临床荟萃》2020年第4期322-325,共4页Clinical Focus

摘　　要：目的对比研究不同步骤方法单支架治疗右冠状动脉后三叉真性分叉病变的临床有效性和安全性。方法选取行冠状动脉造影显示为右冠状动脉后三叉真性分叉病变,并且为冠状动脉单支病变的冠心病患者,根据介入手术步骤分为球囊对吻扩张组(A组)和无球囊对吻扩张组(B组);A组又分为支架前球囊对吻扩张组(A1组)、支架后球囊对吻扩张组(A2组)。观察介入并发症发生率、X线暴露时间及造影剂用量、术后1年的临床主要不良心脏事件及术后1年支架内再狭窄情况。结果A2组比A1组术中并发症慢血流、心绞痛及术后1年造影显示冠状动脉血流不达TIMI3级发生率更低(P<0.05)。A组较B组术中并发症慢血流、心绞痛及术后1年造影显示冠状动脉血流不达TIMI3级发生率更低(P<0.05)。各组介入X线暴露时间及造影剂用量差异无统计学意义。结论单支架治疗右冠后三叉真性分叉病变时采取球囊对吻扩张较无球囊对吻扩张治疗术后1年临床主要不良心脏事件发生率更低;其中支架后球囊对吻扩张较支架前球囊对吻扩张的介入方法并发症发生率及术后1年的临床主要不良心脏事件发生率更低。Objective To compare the clinical efficacy and safety of treatment of trigeminal lesions after right coronary artery with single stent by different methods.Methods Patients with coronary heart disease who underwent coronary angiography showing a right tricuspid trigeminal true bifurcation lesion and a single-branch coronary artery lesion were selected.According to the steps of interventional surgery,the patients were divided into the balloon kissingdilation group(group A)and the non-balloon kissingdilation group(group B).Group A was further divided into two groups:group A1 and group A2.The incidence of interventional complications,X-ray exposure time,the dosage of contrast medium,major adverse cardiac events and stent restenosis were observed 1 year after surgery.Results Compared with group A1,the incidence of intraoperative complications such as slow blood flow,angina pectoris and coronary artery blood flow not reaching TIMI3 in angiography one year later in group A2 was lower(P<0.05).Compared with group B,group A had lower incidence of intraoperative complications such as slow blood flow,angina pectoris and coronary artery blood flow not reaching TIMI3 in angiography one year later(P<0.05).There was no significant difference in X-ray exposure time and the dosage of contrast medium.Conclusion In the treatment of right tricuspid trigeminal true bifurcation lesion with a single-branch coronary artery lesion,the incidence of major clinical adverse cardiac events in one year after balloon dilatation was lower than that without balloon dilatation,and the incidence of complications and major adverse cardiac events in one year after post-stent dilatation was lower than that in the pre-stent balloon dilatation.

关 键 词：冠心病 后三叉 介入治疗 单支架 

分 类 号：R541.4[医药卫生—心血管疾病]