拘禁球囊技术在冠心病介入治疗非左主干分叉病变边支保护中的即刻及近期疗效分析
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摘要
目的探讨拘禁球囊技术对冠心病介入治疗(PCI)非左主干分叉病变边支保护中的即刻及近期疗效的影响,为临床应用提供参考依据。方法方便选取该院2016年1月—2018年1月收治冠心病非左主干分叉病变患者92例,随机分为研究组和对照组。研究组46例,在PCI治疗过程中应用拘禁球囊技术;对照组46例,予以球囊对吻技术。比较两组术中、术后表现,并随访6个月,记录心血管不良事件和再狭窄发生率。结果研究组中,PCI操作时间为(55.12±3.26)min、X线曝光时间为(9.12±1.27)min、造影剂用量为(90.16±5.17)mL、植入DES数量为(1.45±0.72)枚、手术费用为(2.91±0.56)万元,均明显低于对照组,差异有统计学意义(t=28.485、27.978、49.183、5.656、6.170,P<0.01)。研究组出现2例边支闭塞、1例肌钙蛋白升高,并发症发生率为6.52%,与对照组相比较,差异无统计学意义(χ2=0.137,P>0.05)。研究组患者中,出现1例心绞痛、1例心肌梗死,MACE发生率4.35%,再狭窄发生率为2.17%,与对照组的8.70%、2.17%相比较,差异无统计学意义(χ2=0.178、0.511,P>0.05)。结论拘禁球囊技术即刻与近期疗效与传统球囊技术无显著差异,但手术步骤更简化、费用更低廉,具有良好安全性及可靠性,值得临床推广应用。
Objective To investigate the effect of detained balloon technique on the immediate and short-term effects of coronary artery disease interventional therapy(PCI) in the treatment of non-left main bifurcation lesions, and provide a reference for clinical application. Methods Convenient select a total of 92 patients with non-left main bifurcation lesions of coronary heart disease were enrolled in the hospital from January 2016 to January 2018. They were randomly divided into study group and control group. 46 patients in the study group were treated with balloon technique during PCI treatment, and46 patients in the control group were given balloon-to-kiss technique. The intraoperative and postoperative performances of the two groups were compared and followed up for 6 months. The incidence of cardiovascular adverse events and restenosis was recorded. Results In the study group, PCI operation time was(55.12±3.26) min, X-ray exposure time was(9.12±1.27)min, contrast agent dosage was(90.16±5.17)mL, and the number of implanted DES was(1.45±0.72). The cost of surgery and surgery was(2.91±0.56) ten thousands, which was significantly lower than that of the control group, the different was statistically significant(t=28.485, 27.978, 49.183, 5.656, 6.170, P<0.01). There were 2 cases of collateral occlusion and 1 case of troponin elevation in the study group. The complication rate was 6.52%. Compared with the control group, the difference was not statistically significant(χ2=0.137, P>0.05). Among the patients in the study group, 1 patient had angina pectoris and 1 patient had myocardial infarction. The incidence of MACE was 4.35%, and the incidence of restenosis was 2.17%.Compared with 8.70% and 2.17% of the control group. The difference is not statistically significant(χ2=0.178, 0.511, P>0.05). Conclusion The balloon technique is not significantly different from the short-term efficacy and traditional balloon technique. However, the surgical procedure is more simplified and cheaper. It has good safety and reliability and is worthy of clinical application.
Objective To investigate the effect of detained balloon technique on the immediate and short-term effects of coronary artery disease interventional therapy(PCI) in the treatment of non-left main bifurcation lesions, and provide a reference for clinical application. Methods Convenient select a total of 92 patients with non-left main bifurcation lesions of coronary heart disease were enrolled in the hospital from January 2016 to January 2018. They were randomly divided into study group and control group. 46 patients in the study group were treated with balloon technique during PCI treatment, and46 patients in the control group were given balloon-to-kiss technique. The intraoperative and postoperative performances of the two groups were compared and followed up for 6 months. The incidence of cardiovascular adverse events and restenosis was recorded. Results In the study group, PCI operation time was(55.12±3.26) min, X-ray exposure time was(9.12±1.27)min, contrast agent dosage was(90.16±5.17)mL, and the number of implanted DES was(1.45±0.72). The cost of surgery and surgery was(2.91±0.56) ten thousands, which was significantly lower than that of the control group, the different was statistically significant(t=28.485, 27.978, 49.183, 5.656, 6.170, P<0.01). There were 2 cases of collateral occlusion and 1 case of troponin elevation in the study group. The complication rate was 6.52%. Compared with the control group, the difference was not statistically significant(χ2=0.137, P>0.05). Among the patients in the study group, 1 patient had angina pectoris and 1 patient had myocardial infarction. The incidence of MACE was 4.35%, and the incidence of restenosis was 2.17%.Compared with 8.70% and 2.17% of the control group. The difference is not statistically significant(χ2=0.178, 0.511, P>0.05). Conclusion The balloon technique is not significantly different from the short-term efficacy and traditional balloon technique. However, the surgical procedure is more simplified and cheaper. It has good safety and reliability and is worthy of clinical application.
引文
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[4]陈耀贵,杜岗,边宁,等.冠状动脉分叉病变血管内超声指导下拘禁球囊分支保护联合单支架跨越技术临床观察[J].广东医学,2017,38(s2):71-73.
[5]程轶,杨洋,陈磊磊,等.边支球囊潜埋技术与传统导丝保护治疗冠心病真性分叉病变的临床观察[J].南京医科大学学报:自然科学版,2017(1):81-84.
[6]赵宇,白静,刘庆艳,等.药物涂层球囊在冠状动脉分叉病变边支介入治疗中的临床应用[J].中华老年心脑血管病杂志,2017,19(4):388-390.
[7]李爱琴,郑海军,杨长宝,等.桡动脉径路行冠状动脉分叉病变球囊保护边支技术可行性的临床研究[J].中国实用医刊,2015,42(17):17-18.
[8]张雨虹,贺铿,袁国军,等.拘禁球囊技术在冠心病介入治疗分叉病变分支保护中的即刻及近期临床疗效观察[J].江西医药,2014(12):1377-1381.
[2]张强,王慧峰,王凤群,等.主动球囊边支保护技术在治疗冠状动脉分叉病变中的边支保护效果评价[J].中西医结合心脑血管病杂志,2016,14(4):413-416.
[3]赖浚兴,谭文峰,莫兹清,等.球囊支架对吻技术与拘禁球囊技术治疗冠状动脉分叉病变对边支的保护作用比较[J].河南医学研究,2017(21):3875-3876.
[4]陈耀贵,杜岗,边宁,等.冠状动脉分叉病变血管内超声指导下拘禁球囊分支保护联合单支架跨越技术临床观察[J].广东医学,2017,38(s2):71-73.
[5]程轶,杨洋,陈磊磊,等.边支球囊潜埋技术与传统导丝保护治疗冠心病真性分叉病变的临床观察[J].南京医科大学学报:自然科学版,2017(1):81-84.
[6]赵宇,白静,刘庆艳,等.药物涂层球囊在冠状动脉分叉病变边支介入治疗中的临床应用[J].中华老年心脑血管病杂志,2017,19(4):388-390.
[7]李爱琴,郑海军,杨长宝,等.桡动脉径路行冠状动脉分叉病变球囊保护边支技术可行性的临床研究[J].中国实用医刊,2015,42(17):17-18.
[8]张雨虹,贺铿,袁国军,等.拘禁球囊技术在冠心病介入治疗分叉病变分支保护中的即刻及近期临床疗效观察[J].江西医药,2014(12):1377-1381.