药物涂层球囊扩张成形术用于合并冠心病的肿瘤限期手术患者的效果研究  

Drug-coated balloon angioplasty in confined surgery for patients with tumor complicated by coronary heart disease

作　　者：谢力民[1] 徐雪飞 王晓明[1] 董金虎 王记培 杨鹏伟[1] Xie Limin;Xu Xuefei;Wang Xiaoming;Dong Jinhu;Wang Jipei;Yang Pengwei(Henan Provincial Chest Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省胸科医院,郑州450000

出　　处：《中国实用医刊》2024年第7期10-12,共3页Chinese Journal of Practical Medicine

基　　金：河南省联合共建项目(LHGJ20190736)。

摘　　要：目的探讨合并冠心病的肿瘤限期手术患者应用冠状动脉药物涂层球囊(DCB)扩张成形术的临床效果。方法回顾性抽取2019年2月至2023年2月河南省胸科医院收治的冠状动脉重度狭窄合并肿瘤限期手术患者136例,所有患者均行DCB扩张成形术处理冠状动脉重度狭窄情况,DCB术后应用双联抗血小板(DAPT)治疗1个月,然后行肿瘤相关手术。记录患者的相关临床资料,记录患者DCB手术围术期急性心血管事件发生率、手术成功率、出血率等,并记录患者肿瘤手术后的心源性死亡、非心源性死亡、急性心肌梗死、恶性心律失常、出血、再次冠状动脉血运重建等术后不良事件发生率及复合终点。结果136例患者均安全完成DCB手术,手术成功率100%(136/136)。无院内急性心血管事件发生,满足肿瘤限期手术的时间要求。DCB术后发生消化道出血4例(2.94%,4/136),均为消化道肿瘤患者;发生泌尿系统出血2例(1.47%,2/136),均为泌尿系统肿瘤患者;均未输血。中位随访时间为18.8个月,随访中3例患者死亡,均为非心源性死亡;2例出血,均为消化系统出血;9例DCB术后再发心绞痛,再次入院行药物洗脱支架植入术;无急性及晚期血栓形成事件发生。结论冠状动脉DCB扩张成形术极大的缩短了DAPT时间,且出血风险小、心血管事件发生率低,在合并冠心病的肿瘤限期手术患者中具有较高的应用价值。Objective To investigate the clinical efficacy of drug-coated balloon(DCB)angioplasty in confined surgery for patients with tumor complicated by coronary heart disease.Methods A total of 136 patients required for confined surgery for tumor complicated by severe coronary artery stenosis in Henan Provincial Chest Hospital from February 2019 to February 2023 were retrospectively selected as the study objects.They all underwent DCB angioplasty and reconstruction surgery for severe coronary stenosis.After DCB surgery,the patients were treated with dual antiplatelet(DAPT)for 1 month,and then the tumor related surgery was performed.The relevant clinical data of the patients were recorded;the incidence of acute cardiovascular events,surgical success rate,and bleeding rate during the perioperative period of DCB surgery were recorded;the incidence and composite endpoint of postoperative adverse events such as cardiac death,non cardiac death,acute myocardial infarction,malignant arrhythmia,bleeding,and revascularization after tumor surgery in patients were recorded.Results All 136 patients safely completed DCB surgery,the success rate of the operation was 100%(136/136).No acute cardiovascular event occurred in the hospital,and the time requirement of tumor operation was met.After DCB surgery,there were 4 cases(2.94%,4/136)of gastrointestinal bleeding,all of whom were patients with digestive tract tumors;and 2 cases(1.47%,2/136)of urinary system bleeding occurred,both of which were with urinary system tumors;and none of them had blood transfusion.The median follow-up time was 18.8 months;during the follow-up,3 cases died,all of which were non-cardiac deaths;hemorrhage occurred in 2 cases,all of which were digestive system hemorrhage;and 9 cases had angina pectoris after DCB,and received DCB again after admission.There was no acute or late thrombosis event.Conclusions The coronary artery DCB angioplasty can greatly reduce the DAPT time,risk of bleeding and incidence of cardiovascular events,which has high application value in

关 键 词：冠心病 肿瘤限期手术 药物球囊扩张成形术 围术期 

分 类 号：R654.2[医药卫生—外科学] R730.5[医药卫生—临床医学]