主支支架加边支预埋球囊治疗冠状动脉分叉病变的疗效及安全性观察

目的 探讨主支支架加边支预埋球囊治疗冠状动脉分叉病变的临床疗效及手术安全性.方法 以江苏省徐州市中心医院2012年10月至2013年7月收治的冠状动脉分叉病变患者86例为研究对象,采用主支支架加边支预埋球囊术进行治疗.依据研究组患者的基线资料特点,选取行单导丝边支保护的60例边支病变患者为对照组.术后,对比评价两组患者的介入治疗成功率、并发症发生率以及随访1年后的心肌梗死溶栓试验（thrombolysis in myocardial infarction,TIMI）血流分级、TIMI心肌灌注（TIMI myocardial perfusion,TMP）血流分级等.结果 术后,研究组和对照组的介入治疗成功率分别为98.84％和85.71％,并发症发生率分别为1.16％和11.11％,组间比较差异具有统计学意义（P＜0.05）.随访1年期间,研究组的主要心血管事件发生率低于对照组,差异具有统计学意义[6.98％（6/86） vs.31.75％（20/63） P＜0.05];TIMI血流分级、TMP血流分级以及右心室舒张末期内径和右心室射血分数均优于对照组,差异具有统计学意义（P＜0.05）.结论 主支支架加边支预埋球囊可提高冠状动脉分支病变患者的介入治疗成功率,降低并发症的发生率,血运重建效果良好,具有较好的远期疗效.

Investigation on the clinical efficacy and safety of main branch stenting combined with jailed balloon technique on side branch in patients with coronary bifurcation lesions

Objectives To investigate the clinical efficacy and safety of main branch stenting combined with jailed balloon technique on side branch in patients with coronary bifurcation lesions.Methods Totally 86 patients with coronary bifurcation lesions in The Central Hospital of Xuzhou City from October 2012 to July 2013 were selected in this study.The treatment program was main branch stenting and jailed balloon technique on side branch.According to baseline data,60 patients received one-wire protection of side branch were in control group.Success rate,incidence of complications after surgery,thrombolysis in myocardial infarction （TIMI） grade and TIMI myocardial perfusion （TMP） grade during 1-year follow-up were compared between the two groups.Results Success rate and incidence of complications were 98.84% and 1.16% in treatment group,85.71% and 11.11% in control group.The differences were statistically significant （P〈0.05）.In the period of 1-year follow-up,incidence of main adverse coronary events （MACE）in treatment group was significantl lower than that in control group [6.98% （6/86） vs.31.75% （20/63）,P〈0.05];TIMI grade,TMP grade,right ventricular end-diastolic dimension （RVEDD） and right ventricular ejection fraction （RVEF） were significantly better than those in control group （P〈0.05）.Conclusions Main branch stenting combined with jailed balloon technique on side branch can improve the success rate of interventional treatment for coronary bifurcation lesions,reduce the incidence of complications,which achieves a beneficial impact on revascularization with an excellent long-term clinical effect.