经导管冠状动脉支架植入术治疗冠心病的疗效分析与随访

目的研究分析冠状动脉内支架置入术治疗冠心病心肌梗塞和不稳定心绞痛的安全性和有效性。方法回顾性分析本院2001年1月至2005年5月经皮冠状动脉支架植入术治疗142例冠心病心肌梗塞和不稳定心绞痛患者临床资料,随访评价其近、中期临床疗效和安全性。结果共处理病变血管162支,其中前降支病变79例,回旋支病变24例,右冠脉病变54例,第一钝缘支病变3例,第一对角支病变1例,中间支病变1例,血管平均狭窄程度(92.51±9.05)%,经股动脉途径110例,经桡动脉途径32例,植入支架179个,植入支架的总成功率97.2%,支架平均长度为21.38±5.08 mm,支架的平均直径3.04±0.35 mm,支架释放压力平均为12.55±1.74atm,平均住院天数21.88±11.92 d。主要并发症:死亡3例,发生心肌梗死1例,急性冠脉搭桥1例,术中出现室速、室颤6例,均除颤成功。随访3月~2年,支架植入术后因心脏事件再次住院患者30例(占21.1%),支架内再狭窄8例,均为Medtronic AVE系列裸支架,支架内再狭窄率4.5%,其余患者临床疗效均佳,无心脏事件及心绞痛发生,生活质量较好。结论本组资料显示,冠脉内支架置入术治疗包括复杂病变在内的冠心病心肌梗塞和不稳定心绞痛成功率高,并发症低,疗效确切,是治疗冠脉病变尤其是处理PTCA术中明显内膜撕裂和急性血管闭塞的有效方法。

Clinical Analysis on Intracoronary Stenting of Coronary Artery Disease

Objective To evaluate the results of intracoronary stenting in 142 cases from Jan 2001 to May 2005 in our hospital.Methods The clinical and angiographic results after intracoronary stenting in 142 consecutive patients treated in our hospital from Jan 2001 to May 2005 were retrospectively analyzed.The whole group included 162 vessel lesious.Results There were 162 lesions in total,179 intracoronary stents were implanted in 142 patients with coronary artery disease(CAD),including 89 stents into LAD,25 into LCX and 60 into RCA.Success rate of intracoronary stenting was 97.2%.The complications resulted in three patient died,one patient suffered from Non Q wave myocardid infarction,six patients suffered from ventricular tachycardia(VT)and ventricular fibrillation(VF)during operation.Eight cases(4.5%)had in-tent restenosis between 3 to 24 months after stent implantation.Conclusion Intracoronary stenting is a safe and efficient interventional procedure with a high success rate,fewer complications and good clinical outcomes.