摘要
目的观察"门卫"导丝技术在冠状动脉慢性完全闭塞(CTO)病变患者经皮冠状动脉介入治疗(PCI)中的应用效果。方法选取平顶山市第一人民医院心内科于2015年6月~2017年4月行PCI的冠状动脉CTO病变患者70例,其中男性46例,女性24例,年龄41~75(64.9±3.9)岁。随机分为门卫导丝组(35例)和常规组(35例)。常规组按常规方法行介入治疗,门卫导丝组介入治疗应用"门卫"导丝技术。记录两组X线曝光时间、PCI成功率、对比剂用量、手术相关并发症以及术后30 d主要不良心血管事件(MACE)和次要终点事件,测定两组术前以及术后1个月左室射血分数(LVEF)、6分钟步行距离、脑钠肽(BNP)以及肌酐。结果与常规组比较,门卫导丝组X线曝光时间缩短,PCI成功率增加,对比剂用量减少,[(47.0±10.0)min vs.(40.0±5.1)min],(71.4%vs.91.4%),[(202.9±13.8)ml vs.(193.0±8.1)ml],差异有统计学意义(P均<0.05)。与常规组比较,门卫导丝组手术相关并发症降低(40.0%vs.8.6%),差异有统计学意义(P<0.05)。两组患者术后较术前LVEF、6分钟步行距离、BNP以及肌酐均明显改善,其中门卫导丝组改善更明显,差异具有统计学意义(P均<0.05)。结论与常规导丝技术比较,"门卫"导丝技术可明显提高CTO患者PCI成功率及心功能,降低手术相关并发症。
Objective To observe the application effect of guard wire technique during percutaneous coronary intervention （PCI） in patients with chronic total occlusion （CTO） of coronary artery, Methods The patients with CTO of coronary artery （n=70, male 46, female 24, aged from 41 to 75 and average age=64.9±3.9） were chosen from the Department of Cardiology of the First People’s Hospital of Pingdingshan City from June 2015 to Apr. 2017, and then they were randomly divided into guard wire group and routine group （each n=35）. The routine group was given PCI according to routine procedure, and guard wire group was given PCI by using guard wire technique. The X-ray exposure time, success rate of PCI, dose of contrast agent, PCI-related complications, and major adverse cardiovascular events （MACE） and secondary end-point events after PCI for 30 d were recorded in 2 groups. The indexes of left ventricular ejection fraction （LVEF）, 6-minute walk distance （6MWD）, brain natriuretic peptide （BNP） and serum creatinine （SCr） were detected before and 1 month after PCI. Results The X-ray exposure time was shorter （47.0±10.0） min vs. （40.0±5.1） min, success rate of PCI increased （71.4% vs. 91.4%）, and dose of contrast agent decreased （202.9±13.8） mL vs. （193.0±8.1） mL in guard wire group compared with routine group （all P〈0.05）. The PCI-related complications were decreased in guard wire group compared with routine group （40.0% vs. 8.6%, P〈0.05）. The indexes of LVEF, 6MWD, BNP and SCr were all improved significantly in 2 groups after PCI, and they were improved more significantly in guard wire group （all P〈0.05）. Conclusion Compared with routine technique, guard wire technique can improve the success rate of PCI and heart function, and reduce incidence of PCI-related complications in patients with CTO of coronary artery.
出处
《中国循证心血管医学杂志》
2018年第2期214-217,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
