单根导管技术在老年ST段抬高型心肌梗死患者介入治疗中的应用及效果研究  

Effect of single catheter technique in interventional therapy for elderly ST segment elevation myocardial infarction patients

作　　者：张苡榕 唐一锋 李勇军 柳丽 李翔 梅丽 彭媚 陈保林[2] Zhang Yirong;Tang Yifeng;Li Yongjun;Liu Li;Li Xiang;Mei Li;Peng Mei;Chen Baolin(Department of Cardiology,Liupanshui People􀆳s Hospital,Liupanshui 553000,Guizhou Province,China)

机构地区：[1]六盘水市人民医院心内科,553000 [2]贵州省人民医院心内科

出　　处：《中华老年心脑血管病杂志》2020年第12期1285-1288,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：六盘水市社会发展攻关计划项目[六盘水科发(2018)12号]。

摘　　要：目的研究单根导管技术在老年ST段抬高型心肌梗死(STEMI)患者介入治疗中的应用效果。方法选取行PCI的老年STEMI患者240例,按照随机数字表法分为研究组和对照组,每组120例,研究组使用单根Ikari left(IL)指引导管行冠状动脉造影术(CAG)及PCI,对照组采用常规方法行CAG及PCI。比较2组冠状动脉造影、PCI、PCI相关时间、PCI成功率、术中并发症及主要心血管不良事件(MACE)发生率。结果研究组造影剂用量、进门至球囊扩张(D-TO-B)时间、进入导管室至球囊扩张(C-TO-B)时间、手术时间、透视时间及桡动脉痉挛发生率明显低于对照组,差异有统计学意义[(81.20±14.69)ml vs(89.74±17.37)ml,(65.41±11.72)min vs(73.16±13.54)min,(15.50±3.68)min vs(18.26±3.91)min,(28.01±6.82)min vs(33.07±8.52)min,(7.53±2.09)min vs(10.78±3.80)min,1.67%vs 14.17%,P<0.01]。2组PCI成功率及术中局部血肿发生率比较,差异无统计学意义(P>0.05)。研究组MACE发生率与对照组比较,差异无统计学意义(0.83%vs 3.33%,P=0.175)。结论使用单根IL指引导管对老年STEMI患者行CAG及PCI,可明显减少造影剂用量,缩短D-TO-B、C-TO-B等时间,降低桡动脉痉挛发生率,且术后MACE发生率较少。Objective To study the effect of single catheter technique in interventional therapy for elderly STEMI patients.Methods Two hundred and forty elderly STEMI patients were divided into study group(n=120)and control grou(n=129).The patients in study group underwent single Ikari left guiding catheter-guided coronary angiography(CAG)and PCI and those in control group underwent conventional CAG and PCI.The findings in CAG and PCI,PCI time,PCI success rate,incidence of complications during PCI and MACE were compared between the two groups.Results The dosage of contrast medium was significantly smaller,the D to B time,C to B time,PCI time and fluoroscopy time were significantly shorter,and the incidence of radial artery spasm was significantly lower in study group than in control group(81.20±14.69 ml vs 89.74±17.37 ml,65.41±11.72 min vs 73.16±13.54 min,15.50±3.68 min vs 18.26±3.91 min,28.01±6.82 min vs 33.07±8.52 min,7.53±2.09 min vs 10.78±3.80 min,1.67%vs 14.17%,P<0.05).No significant difference was detected in PCI success rate,incidence of local hematoma during PCI and MACE between the two groups(P>0.05).Conclusion Single Ikari left guiding catheterguided CAG and PCI for elderly STEMI patients can significantly reduce the dosage of contrast medium,D to B time,C to B time,incidence of radial artery spasm and MACE in elderly STEMI patients after PCI.

关 键 词：ST段抬高型心肌梗死 冠状血管造影术 桡动脉 痉挛 

分 类 号：R542.22[医药卫生—心血管疾病]