经皮冠状动脉腔内成形术与支架术治疗冠心病的初步观察(摘要)

中国循环杂志 1999年第0期第14卷 摘要　冠心病介入治疗

作者：齐国先　曾定尹　贾大林　张月兰　贾志梅　于亚媛　李敏　张春梅　赵军

单位：辽宁省沈阳市，中国医科大学第一临床学院　心内科(110001)

　　目的：探讨冠状动脉(冠脉)内支架和经皮冠脉腔内成形术(PTCA)治疗冠心病的应用价值。

　　方法：1992年10月至1998年6月共有110例冠心病患者接受冠脉介入治疗，男性98例，女性12例，平均年龄62.5±12.5岁。临床诊断心绞痛63例，心肌梗塞47例。冠脉造影显示单支病变39例，双支病变60例，三支病变11例。共192支病变血管，左前降支93支，右冠脉65支，左回旋支33支，左主干1支，其中双病变或多病变血管8支。A型病变43支，B型病变93支，C型病变56支。常规方法完成单纯PTCA 63例，冠脉内支架术47例成功。

　　结果：两组患者共192支病变血管，支架组完成59支，PTCA组完成94支，其余39支血管主要由于病变弥散、成角、或闭塞时间长等C型病变未行介入治疗，支架组术后残余狭窄［(5.82±10.2)%］明显小于PTCA组［(38.21±11.3)%］。支架组47例患者59支病变血管共置入5种63枚支架，病变成功率98.31%(58/59)。临床成功率93.62%(44/47)。随访2～12个月(平均6.85±3.94个月)，6例患者出现心绞痛再发症状(13.3%)。63例PTCA术患者，7例扩张失败，病变成功率93.62%(88/94),临床成功率88.89%(56/63)。临床随访18.35±21.56个月，失访9例，11例再发心绞痛。

　　结论：冠脉内介入技术是治疗冠心病的有效措施，冠状动脉内支架术成功率高，并发症少。

Preliminary Observation of Balloon Angioplasty and Coronary-Stent Implantation

　　in the Treatment of Coronary Heart Disease (Abstract)

Department of Cardiology, The First Affilliated Hospital, China Medical University, Shenyang (110001), Liaoning

　　Qi Guoxian, Zeng Dingyin, Jia Dalin, et al.

　　Objective: To assess the clinical value of the coronary-stent implantation and balloon angioplasty in the treatment of coronary heart disease.

　　Methods: One hundred and ten patients with coronary heart disease were treated by intracoronary interventional technique with 47 coronary-stent implantations and 63 balloon angioplasties.

　　Results: Sixty-three stents were implanted into 59 coronary lesion arteries with success of 58 vessels. All patients were followed up for 6.85±3.94 months and angina pectoris were occurred in 6 cases (13.3%). The balloon angioplasty was performed in 94 coronary lesion arteries with success of 88 vessels. In the follow-up periods of 18.35±21.56 months, angina pectoris and acute myocardial infarction were occurred respectively in 11 and 2 cases (24.07%).

　　Conclusion: The intracronary intervetional technique was an effective procedure for treating the coronary heart disease with higher successful rate and lower complications.