中国医药
中國醫藥
중국의약
China Medicine
2015年
9期
1249-1252
,共4页
熊然%刘文娴%陈立颖%宁尚秋%康铁朵%李江%盛瑾%黄觊
熊然%劉文嫻%陳立穎%寧尚鞦%康鐵朵%李江%盛瑾%黃覬
웅연%류문한%진립영%저상추%강철타%리강%성근%황기
经皮冠状动脉介入%双导丝球囊%分叉病变%简单策略
經皮冠狀動脈介入%雙導絲毬囊%分扠病變%簡單策略
경피관상동맥개입%쌍도사구낭%분차병변%간단책략
Percutaneous coronary intervention%Dual wire balloon%Bifurcation lesions%Simple strategy
目的 对比冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊与普通球囊预扩张分支血管的有效性及安全性,为分叉病变治疗策略提供依据.方法 回顾性分析201 1年1月至2014年1月首都医科大学附属北京安贞医院心内科经冠状动脉造影证实为冠状动脉分叉病变的患者162例,共170个分叉病变.按照分支血管处理措施分为双导丝球囊组(DB组,78例)和普通球囊组(PB组,84例),分别给予双导丝球囊和普通球囊预扩张.观察2组患者手术成功率、分支受累情况、并发症及随访主要不良心脏事件(MACEs)发生情况.结果 2组患者临床基线资料与分叉病变受累情况及病变分型比较,差异均无统计学意义(P＞0.05).2组患者主支血管经皮冠状动脉介入治疗成功率比较,差异无统计学意义(P＞0.05),但DB组患者分支血管经皮冠状动脉血管成形术成功率高于PB组[94.0％(79/84)比81.4％ (70/86)],差异有统计学意义(P＜0.05).DB组患者围术期心肌梗死发生率低于PB组[5.1％ (4/78)比17.9％ (15/84)],差异有统计学意义(P＜0.05).术后随访12个月结果表明,DB组MACEs发生率低于PB组患者[6.7％(5/75)比15.0％ (12/80)],差异有统计学意义(P＜0.05).结论 冠状动脉介入简单策略治疗冠状动脉分叉病变过程中,应用双导丝球囊行预扩张对比普通球囊安全、有效,成功率较高,并发症较少,是临床实践中治疗冠状动脉分叉病变安全、有效、可行的方法.
目的 對比冠狀動脈介入簡單策略治療冠狀動脈分扠病變過程中,應用雙導絲毬囊與普通毬囊預擴張分支血管的有效性及安全性,為分扠病變治療策略提供依據.方法 迴顧性分析201 1年1月至2014年1月首都醫科大學附屬北京安貞醫院心內科經冠狀動脈造影證實為冠狀動脈分扠病變的患者162例,共170箇分扠病變.按照分支血管處理措施分為雙導絲毬囊組(DB組,78例)和普通毬囊組(PB組,84例),分彆給予雙導絲毬囊和普通毬囊預擴張.觀察2組患者手術成功率、分支受纍情況、併髮癥及隨訪主要不良心髒事件(MACEs)髮生情況.結果 2組患者臨床基線資料與分扠病變受纍情況及病變分型比較,差異均無統計學意義(P＞0.05).2組患者主支血管經皮冠狀動脈介入治療成功率比較,差異無統計學意義(P＞0.05),但DB組患者分支血管經皮冠狀動脈血管成形術成功率高于PB組[94.0％(79/84)比81.4％ (70/86)],差異有統計學意義(P＜0.05).DB組患者圍術期心肌梗死髮生率低于PB組[5.1％ (4/78)比17.9％ (15/84)],差異有統計學意義(P＜0.05).術後隨訪12箇月結果錶明,DB組MACEs髮生率低于PB組患者[6.7％(5/75)比15.0％ (12/80)],差異有統計學意義(P＜0.05).結論 冠狀動脈介入簡單策略治療冠狀動脈分扠病變過程中,應用雙導絲毬囊行預擴張對比普通毬囊安全、有效,成功率較高,併髮癥較少,是臨床實踐中治療冠狀動脈分扠病變安全、有效、可行的方法.
목적 대비관상동맥개입간단책략치료관상동맥분차병변과정중,응용쌍도사구낭여보통구낭예확장분지혈관적유효성급안전성,위분차병변치료책략제공의거.방법 회고성분석201 1년1월지2014년1월수도의과대학부속북경안정의원심내과경관상동맥조영증실위관상동맥분차병변적환자162례,공170개분차병변.안조분지혈관처리조시분위쌍도사구낭조(DB조,78례)화보통구낭조(PB조,84례),분별급여쌍도사구낭화보통구낭예확장.관찰2조환자수술성공솔、분지수루정황、병발증급수방주요불양심장사건(MACEs)발생정황.결과 2조환자림상기선자료여분차병변수루정황급병변분형비교,차이균무통계학의의(P＞0.05).2조환자주지혈관경피관상동맥개입치료성공솔비교,차이무통계학의의(P＞0.05),단DB조환자분지혈관경피관상동맥혈관성형술성공솔고우PB조[94.0％(79/84)비81.4％ (70/86)],차이유통계학의의(P＜0.05).DB조환자위술기심기경사발생솔저우PB조[5.1％ (4/78)비17.9％ (15/84)],차이유통계학의의(P＜0.05).술후수방12개월결과표명,DB조MACEs발생솔저우PB조환자[6.7％(5/75)비15.0％ (12/80)],차이유통계학의의(P＜0.05).결론 관상동맥개입간단책략치료관상동맥분차병변과정중,응용쌍도사구낭행예확장대비보통구낭안전、유효,성공솔교고,병발증교소,시림상실천중치료관상동맥분차병변안전、유효、가행적방법.
Objective To evaluate the safety and efficacy of predilation of branch vessels with dual wire balloon or conventional balloon during percutaneous coronary intervention (PCI) with simple strategy in treating bifurcation lesions of coronary artery.Methods Totally 162 patients with 170 bifurcation lesions of coronary artery confirmed by coronary angiography who underwent PCI with simple strategy from Janunary 2011 to Janunary 2014 retrospectively analyzed.During PCI,the branch vessels were predilated with dual wire balloon (DB group,78 cases) or conventional balloon (PB group,84 cases).The procedural success rate of PCI and percutaneous transluminal coronary angioplasty (PTCA),involvement of branch vessel,complications and incidence of major adverse cardiac events (MACEs) were compared between the two groups.Results The clinic characteristics,site and Duke classification of bifurcation were not significantly different between the two groups (P ＞ 0.05).The procedural success of PCI for the main vessels was 100％ (84/84) in DB group and 97.7％ (84/86) in PB group,without significant difference (P ＞ 0.05),but the procedural success rate of PTCA for branch vessels in DB group was significantly higher than that PB group [94.0％ (79/84) vs 81.4％ (70/86)] (P ＜ 0.05).The incidence of perioperative myocardial infarction in DB group was significantly lower than that in PB group [5.1％ (4/78) vs 17.9％ (15/84)] (P ＜ 0.05).During 12-months of follow-up,the incidence of MACEs in DB group was significantly lower than that in PB group [6.7％ (5/75) vs 15.0％ (12/80)] (P＜0.05).Conclusion During PCI with simple strategy in treating bifurcation lesions of coronary artery,it is safe and effective to pre-dilate the branch vessels with dual wire balloon,with higher success rate and less complications compared with conventional balloon.
