老年冠心病慢性闭塞病变的介入治疗探讨

目的探讨老年冠心病患者采用经皮冠状动脉介入(PCI)治疗的中短期疗效。方法对102例住院老年患者采用股动脉穿刺后,行球囊扩张,造影显示扩张满意后植入合适支架。术后随访6-32个月。结果102例患者术后临床症状均完全或基本完全缓解。本组患者有19例多支病变患者至少有一支慢性完全闭塞血管经努力而未能开通,无法植入支架。102例患者通过随访6-32个月,其中32例患者接受了冠脉造影复查,有17例患者分别于术后6个月至16个月又出现胸痛、胸闷症状。超声心动图检查射血分数(EF),心功能术后较术前明显改善,P<0.05。结论对冠状动脉慢性完全闭塞的老年患者,无论核素或超声检查是否存在存活心肌,均应尽量进行闭塞病变的介入治疗,以期改善患者的远期预后。

Treatment and probe for chronic blocking pathological changes of coronary heart disease of the aged patients

Objective To investigate long and short term of curative effect of aged coronary heart disease patients by PCI. Methods Using femoral artery puncture on 102 cases of aged patients,the spheroid cyst dilated, and after the angiography displayed satisfying dilation we transplanted the legal stent.After operation the follow up were 6-32 months. Results After the operation,all the patients'symptoms were completely or mainly relieved.Among them there were 19 multi-blood -vessel-pathological-changes patients, and at least one chronic complete blocking blood vessel was not opened despite our effort.Thus the stent could not be transplanted.By the 6-32 months follow-up,32 patients accepted the coronary artery angiography reexamination and 17 patients showed the symptoms of thorax pains and suffocation 6 months and 16 months respectively after the operation.By using the echocardiogram to check their EF,their heart functions were obviously improved.P<0.05. Conclusion For those aged patients whose coronary arteries are chronically complete blocking,when we use either nuclein or ultrasonic to check whether there exists survival myocardium,we should try to conduct the blocking pathological-changes intervention treatment in order to improve the future prognosis of the patients