上海医学
上海醫學
상해의학
SHANGHAI MEDICAL JOURNAL
2009年
12期
1049-1052
,共4页
葛雷%马健英%秦晴%陆浩%姚康%黄榕翀%黄淅勇%张峰%刘学波%王灏%钱菊英%葛均波
葛雷%馬健英%秦晴%陸浩%姚康%黃榕翀%黃淅勇%張峰%劉學波%王灝%錢菊英%葛均波
갈뢰%마건영%진청%륙호%요강%황용충%황석용%장봉%류학파%왕호%전국영%갈균파
慢性完全闭塞病变%经皮介入治疗%调查问卷
慢性完全閉塞病變%經皮介入治療%調查問捲
만성완전폐새병변%경피개입치료%조사문권
Chronic total occlusioN%Percutaneous coronary interventioN%Survey questionnaires
目的 初步调查我国冠状动脉慢性闭塞病变(CTO)介入治疗的现状 在2008中国冠状动脉CTO介入治疗俱乐部(CTOCC)活动进行的同时,对全国45位介入治疗专家进行问卷调查.结果 本次共发出调查问卷45份,收回43份(95.6%).CTO介入治疗时术者通常使用硬导引钢丝(48.8%)或亲水多聚物涂层导引钢丝(44.2%),仅7.0%的术者使用软导引钢丝尝试开通闭塞病变.在硬导引钢丝系列中术者最常使用Miracle系列导引钢丝(34.5%),在亲水涂层多聚物涂层导引钢丝中术者最常使用Pilot系列导引钢丝(33.3%).当第1根导引钢丝无法通过闭塞病变后,术者最常使用的技术为平行导引钢丝技术(71.4%),此时最常使用的导引钢丝为Miracle(46.0%)和Conquest系列导引钢丝(28.6%).CTO介入治疗中血管内超声(IVUS)的使用率较低,93.1%的术者在CTO介入治疗中IVUS的使用率<5%.患者术前行冠状动脉CT检查的比例较低,67.4%的术者其冠状动脉CT检查的使用率<5%.在逆行导引钢丝技术的应用中,仅1个介入中心(2.2%)的手术量>20例.绝大部分术者(83.7%)的手术成功率<80%.结论 与国外CTO介入治疗水平较高的中心相比,国内术者的CTO介入治疗技术仍待进一步提高.为准确了解当前国内CTO的治疗现状,大规模的回顾性分析非常必要.
目的 初步調查我國冠狀動脈慢性閉塞病變(CTO)介入治療的現狀 在2008中國冠狀動脈CTO介入治療俱樂部(CTOCC)活動進行的同時,對全國45位介入治療專傢進行問捲調查.結果 本次共髮齣調查問捲45份,收迴43份(95.6%).CTO介入治療時術者通常使用硬導引鋼絲(48.8%)或親水多聚物塗層導引鋼絲(44.2%),僅7.0%的術者使用軟導引鋼絲嘗試開通閉塞病變.在硬導引鋼絲繫列中術者最常使用Miracle繫列導引鋼絲(34.5%),在親水塗層多聚物塗層導引鋼絲中術者最常使用Pilot繫列導引鋼絲(33.3%).噹第1根導引鋼絲無法通過閉塞病變後,術者最常使用的技術為平行導引鋼絲技術(71.4%),此時最常使用的導引鋼絲為Miracle(46.0%)和Conquest繫列導引鋼絲(28.6%).CTO介入治療中血管內超聲(IVUS)的使用率較低,93.1%的術者在CTO介入治療中IVUS的使用率<5%.患者術前行冠狀動脈CT檢查的比例較低,67.4%的術者其冠狀動脈CT檢查的使用率<5%.在逆行導引鋼絲技術的應用中,僅1箇介入中心(2.2%)的手術量>20例.絕大部分術者(83.7%)的手術成功率<80%.結論 與國外CTO介入治療水平較高的中心相比,國內術者的CTO介入治療技術仍待進一步提高.為準確瞭解噹前國內CTO的治療現狀,大規模的迴顧性分析非常必要.
목적 초보조사아국관상동맥만성폐새병변(CTO)개입치료적현상 재2008중국관상동맥CTO개입치료구악부(CTOCC)활동진행적동시,대전국45위개입치료전가진행문권조사.결과 본차공발출조사문권45빈,수회43빈(95.6%).CTO개입치료시술자통상사용경도인강사(48.8%)혹친수다취물도층도인강사(44.2%),부7.0%적술자사용연도인강사상시개통폐새병변.재경도인강사계렬중술자최상사용Miracle계렬도인강사(34.5%),재친수도층다취물도층도인강사중술자최상사용Pilot계렬도인강사(33.3%).당제1근도인강사무법통과폐새병변후,술자최상사용적기술위평행도인강사기술(71.4%),차시최상사용적도인강사위Miracle(46.0%)화Conquest계렬도인강사(28.6%).CTO개입치료중혈관내초성(IVUS)적사용솔교저,93.1%적술자재CTO개입치료중IVUS적사용솔<5%.환자술전행관상동맥CT검사적비례교저,67.4%적술자기관상동맥CT검사적사용솔<5%.재역행도인강사기술적응용중,부1개개입중심(2.2%)적수술량>20례.절대부분술자(83.7%)적수술성공솔<80%.결론 여국외CTO개입치료수평교고적중심상비,국내술자적CTO개입치료기술잉대진일보제고.위준학료해당전국내CTO적치료현상,대규모적회고성분석비상필요.
Objective To preliminarily evaluate the current status of percutaneous treatment of coronary chronic total occlusions (CTO) in China. Methods Forty-five cardiac interventionalists were surveyed by questionnaire when they were attending the activity organized by the Chronic Total Occlusions Club, China (CTOCC). The questionnaire consisted of 10 questions with multiple choice. Results Forty-three (95.6%) valid questionnaires were collected. Stiff wires (48.8 %) and polymer-coated hydrophilic wires (44.2 %) were commonly used during CTO, and the soft wires were used as the first attempt wire only in 3.6% of patients. Miracle (34.5%) and Pilot (33.3%) series of guide wires were the most frequently used ones. Parallel wire technique was mainly used when the first guide wire failed to cross the lesions, and under such condition Miracle (46 %) and Conquest (28.6%) series of guide wires were usually chosen. The intravascular ultrasound (IVUS)-guided wire was seldom chosen. The application rate of IVUS was less than 5% in 93.1% of the operators. Multi slice computed tomography prior to operation was infrequently performed. The application rate of CT was less than 5% in 67.4% of the operators. The number of patients who received retrograde guide wire technique surpassed 20 only in one (2.2%) interventional center. The success rate was less than 80% in 83.7% of the operators.Conclusion Compared with their overseas counterparts, interventionalists in China need to further improve their technique. To fully understand the situation of CTO in China, large scale retrospective studies are warranted.
