冠脉血管内超声指导冠脉介入的疗效探析  

Analysis of the therapeutic effect of coronary intervention guided by intravascular ultrasound of the coronary arteries

作　　者：李枝怀 LI Zhi-huai(Zhejiang Provincial People's Hospital Bijie Hospital(Bijie First People's Hospital),Bijie 551700,China)

机构地区：[1]浙江省人民医院毕节医院(毕节市第一人民医院),551700

出　　处：《中国实用医药》2024年第12期85-88,共4页China Practical Medicine

摘　　要：目的 分析冠状动脉(冠脉)血管内超声(IVUS)指导冠脉介入的疗效。方法 选取200例接受冠脉介入治疗的冠脉严重病变患者作为观察对象,按照冠脉血管内指导方式的不同分为对照组和观察组,各100例。对照组予以冠脉造影(CAG)指导,观察组予以冠脉IVUS指导。对比两组手术结果 (支架充分贴壁、残余狭窄程度≤20%、血流TIMI 3级占比及手术成功率)、病变冠脉相关参数(最小管腔直径、管腔有效面积、管腔狭窄率)及终点事件(主要不良心血管事件、靶病变血运重建、支架内血栓发生率)。结果 观察组支架充分贴壁、残余狭窄程度≤20%、血流TIMI 3级占比及手术成功率略高于对照组,但无统计学意义(P>0.05)。治疗后,两组病变冠脉最小管腔直径、管腔有效面积、管腔狭窄率均较治疗前改善,且观察组病变冠脉最小管腔直径(3.59±0.64)mm、管腔有效面积(10.30±2.83)mm^(2)大于对照组的(3.20±0.34)mm、(8.29±1.53)mm^(2),管腔狭窄率(15.11±1.72)%低于对照组的(18.41±1.81)%,有统计学意义(P<0.05)。两组主要不良心血管事件、靶病变血运重建发生率对比无统计学意义(P>0.05);观察组支架内血栓发生率1.00%低于对照组的8.00%,有统计学意义(P<0.05)。结论 在冠脉介入治疗过程中,采用冠脉IVUS指导可提供较为准确的病变冠脉相关参数,降低管腔狭窄率及支架内血栓发生率,具有操作简单、无创伤等优点,值得在临床推广。Objective To analyze the therapeutic effect of coronary intervention guided by intravascular ultrasound(IVUS)of the coronary arteries.Methods 200 patients with severe coronary lesions who received coronary intervention were selected as the observation subjects.They were divided into a control group and an observation group according to the different methods of coronary artery endovascular guidance,with 100 patients in each group.The control group was guided by coronary angiography(CAG),and the observation group was guided by intravascular ultrasound of the coronary arteries.Both groups were compared in terms of surgical results(sufficient stent adhesion,residual stenosis≤20%,TIMI grade 3 flow and surgical success rate),diseased coronary parameters(minimal lumen diameter,effective lumen area,lumen stenosis rate)and endpoint events(major adverse cardiovascular events,target lesion revascularization,and incidence of stent thrombosis).Results The percentages of sufficient stent adhesion,residual stenosis≤20%,TIMI grade 3 flow and surgical success rate in the observation group were slightly higher than those in the control group,but there was no statistical significance(P>0.05).After treatment,the minimal lumen diameter,effective lumen area and lumen stenosis rate were improved in both groups compared with those before treatment;the observation group had minimal lumen diameter of(3.59±0.64)mm and effective lumen area of(10.30±2.83)mm^(2),which were higher than(3.20±0.34)mm and 2(8.29±1.53)mm in the control group;the observation group had lower lumen stenosis rate of(15.11±1.72)%than(18.41±1.81)%in the control group;there was statistical significance(P<0.05).There was no statistical significance in the incidence of major adverse cardiovascular events and target lesion revascularization between the two groups(P>0.05).The incidence of stent thrombosis in the observation group was 1.00%,which was lower than the control group's 8.00%,and there was statistical significance(P<0.05).Conclusion In the process of perc

关 键 词：血管内超声指导 冠状动脉介入 手术成功率 病变冠状动脉参数 支架内血栓 管腔狭窄率 

分 类 号：R541.4[医药卫生—心血管疾病]