经皮冠状动脉介入术中联合经皮冠状动脉旋磨术治疗重度冠状动脉钙化冠心病 57例疗效及安全性观察

目的 观察经皮冠状动脉(冠脉)旋磨术(PTCRA)在冠状动脉重度钙化病变经皮冠脉介入术(PCI)治疗中的疗效及安全性.方法 回顾性分析2017年5月至2019年5月在六盘水市人民医院接受PCI治疗的冠心病114例,从中选取57例单纯PCI治疗的冠状动脉无～中度钙化冠心病纳入单纯组,另选取57例PCI联合PTCRA治疗的冠状动脉重度钙化冠心病纳入旋磨组,对比两组的一般资料、身体检查资料、罪犯血管特征、介入治疗指标,统计旋磨组病人旋磨术中指标,统计两组术后并发症情况;随访1年,分析两组无病情进展生存时间与总生存时间.结果 两组病人身体检查各项指标与一般资料均差异无统计学意义(P=0.05);旋磨组球囊用量(2.39±0.78)个比(2.97±0.91)个]、预扩张次数(2.76±1.18)次比(4.26±1.43)次]均低于单纯组,差异有统计学意义(P<0.05),其他各项罪犯血管特征与介入治疗指标均差异无统计学意义(P=0.05);旋磨组旋磨头直径为(1.43±0.09)mm,旋磨头/靶血管动脉比值为(0.52±0.04),旋磨头转速为(17.67±1.71)万r/min;旋磨组术后并发症发生率为5.26％,单纯组为21.05％,旋磨组低于单纯组差异有统计学意义(P<0.05);随访1年,两组无病情进展生存时间(PFS)与总生存时间(OS)均差异无统计学意义(P=0.05).结论 经皮冠脉旋磨术应用于冠脉重度钙化病变PCI治疗中,能够有效提高PCI治疗的安全性,降低并发症发生风险,对于重度钙化、复杂性冠脉病变的PCI治疗具有重要意义作用.

Observation on the efficacy and safety of percutaneous coronary rotation grinding in PCI for severe calcification

Objective To observe the efficacy and safety of percutaneous coronary rotation grinding (PTCRA) for percutaneous coronary intervention (PCI) in patients with severe calcification.Methods Were retrospectively analyzed in May 2017 to May 2019 in Liupanshui People''s Hospital treated with PCI in patients with coronary heart disease data,choose the 57 patients with pure PCI treatmentno-moderate calcified into simple groups,the selection of 57 cases with PCI PTCRA treatment of patients with seere calcification inspinning mill group, compared two groups of patients with general information,physical examination data,criminal vascular characteristics, intervention indicators,statistical rotary screw grinding mill group patients intraoperative indicators, statistics of two groups of postoperative complications;The survival time without disease progression and the total survival time of the two groups were analyzed.Re? sults There was no statistically significant difference between the physical examination indexes and general data between the two groups(P = 0.05).The balloon dosage(2.39±0.78) vs.(2.97±0.91)] and predilation times(2.76±1.18) vs. (4.26±1.43)] in the rotary grinding group were lower than those in the simple group, with statistically significant differences (P < 0.05).There were no statistically significant differences in the vascular characteristics and interventional treatment indicators of other criminals (P = 0.05). In the mean rotating mill group,the diameter of the rotating mill head was (1.43±0.09)mm,the average rotating mill head/target artery ratio was 0.52±0.04,and the average rotating mill head rotation speed was (17.67±1.71)×104 r/min.The incidence of postoperative complications was5.26% in the rotating mill group and 21.05% in the simple mill group, and the difference was statistically significant(P < 0.05). After follow-up for one year, there was no statistically significant difference in PFS and OS between the two groups(P = 0.05).Conclusion percutaneous coronary rotation grinding can effectively improve the safety of PCI and reduce the risk of complications in the treatmentof severe coronary artery calcification,which is of great significance for the treatment of severe calcification and complex coronary arterydiseases.