摘要
目的 通过在县级医院心内科对冠状动脉慢性完全闭塞(CTO)病变患者采用逆向导丝技术开通病变,评价其安全性和有效性,探索县级医院独立开展该项技术的可行性。方法 70例CTO病变患者,采用逆向导丝技术开通病变。观察患者手术成功率、并发症发生率,手术前后左室射血分数、生活质量评分,术后1年再次心肌梗死及支架内再狭窄情况、左室射血分数、再入院治疗情况。结果 患者一次手术成功率为91.4%(64/70),二次手术成功率为4.3%(3/70),手术失败率为4.3%(3/70);并发症发生率为4.3%(3/70),其中冠状动脉闭塞段夹层、血肿患者各1例,心包填塞患者1例,无死亡患者。术前,患者左室射血分数为(34.5±5.46)%,生活质量评分为(71.65±7.43)分;术后,患者左室射血分数为(58.43±6.12)%,生活质量评分为(93.42±6.11)分。术后,患者左室射血分数、生活质量评分均明显高于术前,差异有统计学意义(P<0.05)。术后1年无再次心肌梗死、支架内再狭窄发生,左室射血分数为(59.16±6.42)%, 3例手术失败患者再次通过逆向导丝技术治疗,手术成功。结论 CTO病变患者采用逆向导丝技术进行治疗,手术成功率较高,且手术效果良好,并发症发生率较低,可以有效改善患者心功能,提高生活质量,预后效果也相对良好,由此来看,在县级医院独立开展此项技术是可行的。
Objective To evaluate the safety and effectiveness of retrograde wire technique in patients with chronic total occlusion(CTO) of coronary artery in the Department of Cardiology of county-level hospital, and to explore the feasibility of independent development of this technology in county-level hospital. Methods In 70 patients with CTO lesions, retrograde wire technique was used to recanalize the lesions. All patients were observed for the success rate of surgery, complication rate, left ventricular ejection fraction and quality of life score before and after the surgery, and the presence of recurrent myocardial infarction, in-stent restenosis, left ventricular ejection fraction and readmission to hospital at 1 year after surgery. Results The success rate of the first surgery was 91.4%(64/70), the success rate of the second surgery was 4.3%(3/70), and the failure rate of surgery was 4.3%(3/70);the complication rate was 4.3%(3/70), including 1 patient with coronary occlusion segment dissection, 1 patient with hematoma, 1 patient with cardiac tamponade, and no deaths. Before surgery, the left ventricular ejection fraction was(34.5±5.46)%, and the quality of life score was(71.65±7.43) points;after operation, the left ventricular ejection fraction was(58.43±6.12)%, and the quality of life score was(93.42±6.11) points. After surgery, the left ventricular ejection fraction and quality of life scores of patients were significantly higher than those before surgery, and the difference was statistically significant(P<0.05). 1 year after surgery, there were no occurrence of recurrent myocardial infarction and in-stent restenosis, and the left ventricular ejection fraction was(59.16±6.42)%. 3 patients with failed surgery were treated again by the retrograde wire technique,and the surgery was successful. Conclusion Patients with CTO lesions treated with the retrograde wire technique have a high success rate and good surgical results with a low complication rate, which can effectively improve the patient’s cardiac funct
作者
张钰彬
许勇
黄恺悦
龙维英
杨武成
ZHANG Yu-bin;XU Yong;HUANG Kai-yue(People's Hospital of Yuechi County,Guangan 638399,China)
出处
《中国实用医药》
2022年第11期41-43,共3页
China Practical Medicine
关键词
逆向导丝技术
冠状动脉慢性完全闭塞病变
手术成功率
心功能
Retrograde wire technique
Chronic total occlusion of coronary artery
Surgical success rate
Cardiac function
