冠状动脉支架置入术后发生胸痛的原因及处理

目的:探讨冠状动脉支架置入术后胸痛的发生率、影响因素及处理.方法:回顾分析过去30个月内行支架置入术的580例冠状动脉疾病患者的术后胸痛情况.其中男408例,女172例,平均年龄63.4岁.围手术期给予阿司匹林、氯吡格雷抗栓,低分子肝素抗凝,扩张冠状动脉,降血脂,控制危险因素和调整生活方式.结果:术后有78例患者出现明显胸痛,发生率为13.45%(78/580).由血栓形成、慢血流、边支闭塞和快速心律失常所致的缺血性胸痛32例,发生率为5.51%(32/580);精神焦虑、支架置入反应、胃食管疾病等所致非缺血性胸痛46例,占7.93%(46/580).结论:冠状动脉支架置入术后胸痛的发生率较高,部分是心肌缺血的表现,要高度重视,积极干预.

Frequency,influence factors and treatment of chest pain after intracoronary stent implantation

Objective:To evaluate frequency,influence factors and treatment of chest pain after intracoronary stent implantation.Methods:Intracoronary stenting was performed in 580 indicated patients with coronary artery disease during the last 30 months,which included 408 males and 172 females with an average age of 63.4 years.In pre- and post interventional procedure,medical treatment of antiplatelet with aspirin and clopidogrel,anticoagulation with low-moleclar-weight heparin,dilating coronary,devalution of blood lipids,risk factors control were carried out in all patients and chest pain was recorded in all of them.Results:Of the 580 patients who underwent successful intracoronary stent,78(13.45%) patients presented chest pain.Chest pain was caused by myocardial ischemia in 32(5.51%) patients who had stent thrombosis,slow flow,side branch occlusion,arrhythmia.Chest pain of non myocardial ischemia occurred in 46(7.93%) patients who had stent dilating,anxiety,esophagogastric trouble.Conclusion:A high incidence of chest pain after intracoronary stent implantation was observed in our patients,and some of them represented myocardial ischemia .therefore we must pay attention to it and treat them actively.