单中心九年冠状动脉介入治疗围术期患者死亡原因的探讨

目的探讨PCI围术期患者死亡的原因。方法选择2002年1月～2010年12月行PCI患者5225例,记录围术期死亡患者的基线临床资料、冠状动脉病变特点、死亡时间及死亡原因。结果围术期患者共死亡54例,病死率1.03%,54例死亡患者中,单支病变13例,双支病变11例,3支病变30例;19例(35.2%)死于术后第1天、20例(37.0%)死于术后2～8d;有18例(33.3%)死于心源性休克、9例(16.7%)死于支架内血栓形成、7例(12.9%)死于严重左心衰竭。结论 PCI围术期死亡发生率低,且多发生在急诊PCI、老年、多支病变患者。引起死亡原因多为心源性休克、支架内血栓形成、严重左心衰竭等。

Causes of death in coronary artery disease patients undergoing PCI during perioperative period in a single center

Objective To study the causes of death in patients with coronary artery disease(CAD)undergoing PCI during perioperative period.Methods A total of 5225 CAD patients who underwent PCI during perioperative period from January 2002 to December 2010 in our hospital were included in this study.Their clinical data,features of CAD,time and causes of death during perioperative period were recorded.Results Fifty-four CAD patients died during perioperative period with a death rate of 1.03%.Of the 1337 emergency patients who underwent PCI,39 died with a death rate of 2.92%.Of the 3888 patients who underwent PCI on a selective day,15 died with a death rate of 0.39%.Of the 54 patients who died during perioperative period,19 died on day 1 after PCI with a death rate of 35.2%,18 died of cardiogenic shock with a death rate of 33.3%,9 died of thrombosis in stents with a death rate of 16.7%,and 7 died of severe left heart failure with a death rate of 12.9%.Conclusion The death rate of patients undergoing PCI during perioperative period is low.Death usually occurs in elderly CAD patients with multiple coronary artery branch lesions,especially in emergency department.The common causes of death are cardiogenic shock,thrombosis in stents,and severe left heart failure.