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直接冠脉支架植入术在冠心病并左心功能不全中的应用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第3期
页码:
213-216
栏目:
临床研究
出版日期:
2002-05-01

文章信息/Info

Title:
Direct stenting in coronary artery disease patients with severe ventricular dysfunction
作者:
臧红云1;  韩雅玲2;  荆全民2;  王守力2;  苗志林2;  王冬梅2;  王祖禄2
1.第四军医大学西京医院心内科, 陕西 西安 710032; 2.沈阳军区总医院心内科, 辽宁 沈阳 110016
Author(s):
ZANG Hong-yun1;  HAN Ya-ling2;  JING Quan-min2;  WANG Shou-li; MIAO Zhi-lin;  WANG Dong-mei; WANG Zu-lu
1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an,Shaanxi 710032; 2.Department of Cardiology, Shenyang Military General Hospital, Shengang,Liaoning 110016, China
关键词:
冠状动脉疾病;  直接支架术;  心力衰竭
Keywords:
cronary disease;  direct stent implantation;  heart failure
分类号:
R318.11;R543.3
DOI:
-
文献标识码:
A
摘要:
目的 评价直接冠脉支架植入术在冠心病左心功能不全应用的安全性和疗效。方法 189 名冠心病左心功能不全患者随机分成未预扩直接植入支架术(Ⅱ组, n= 95)和预扩后植入支架术(Ⅱ组, n= 94) 两组, 观察两组X 线暴光时间、手术时间、造影剂用量、手术费用和心功能情况, 左心功能通过N YHA 分级和超声心动图(UCG) 评价。结果 Ⅱ组X 线暴光时间、手术时间、造影剂用量、球囊导管用量(分别是10±5 min, 21±5 min, 93±10 ml, 2 根) 均低于Ⅱ组(分别是15±2 min, 4±10 m in, 136±23 m l, 94 根) , 4 项数据两组间均有显著性差异(P < 0. 05) ; 围手术期心功能恶化者? 组(2 例) 明显低于? 组(25 例) , P < 0. 05 ; U CG 测左室射血分数(LVEF ) 和左心室内径(LVID) : Ⅱ组术前LV EF 为(41±10)% , 术后3月为(54±12)% , P<0.05,LVID 术前59±5 mm , 术后3 个月为52±5 mm , P<0.05; Ⅱ组术前LVEF为(40±11)% , 术后3月为(52±10)% , P<0.05,LVID 术前59±5mm , 术后3月为53±6 mm , P< 0.05 ; 术后3个月LVEF和LVIDⅡ组和Ⅱ组无明显差异。结论 直接支架术改善冠心病左心功能不全较预扩支架术疗效明显, 且减少手术时间、造影剂用量及手术费用, 值得推广。
Abstract:
AIM To evaluate the safety and feasibility of direct stent implantation in coronary artery disease with severe ventricular dysfunction.METHODS 189 cases with severe ventricular dysfunction were divided into two groups who underwent stenting without (groupⅠ,n=95) and with (groupⅡ,n=94) predilation. The differences between the two groups in radiation exposure time, procedure time,the amount of dye, cost and heart function were assessed . The heart function was determined by NYHA functional class and LVEF tested by UCG.RESULTS The radiation exposure time, procedure time, amount of dye and balloon were lower in groupⅠthan those in groupⅡ(P<0.05). There were more patients whose heart function worsened during perioperation in groupⅡ(25 case) than in groupⅠ(2 case),P<0.05. LVEF values before and 3 months after the operation were (41±10)% and (54±12)% in groupⅠ(P<0.05),and (41±11)% and (52±10)% in groupⅡrespectively (P<0.05); LVID values before and 3 months after the operation were 59±5 mm and 52±5 mm (P<0.05) in groupⅠ,and 59±5 mm and 53±6 mm (P<0.05) in groupⅡrespectively. There was no difference in LVEF and LVID between the two groups 3 months after the operation.CONCLUSION In coronary heart disease patients with severe ventricular dysfunction, direct stenting without balloon predilation can improve their heart function more significantly than predilation. This technique reduced radiation exposure time, procedure time, and the amount of dye and balloon, and was safe and feasible.

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备注/Memo

备注/Memo:
收稿日期：2001-11-12.
更新日期/Last Update: 2005-05-01