摘要
目的探讨老年女性复杂高危冠心病患者经皮冠状动脉介入(PCI)治疗中应用体外膜肺氧合(ECMO)的有效性和安全性。方法回顾性选取2018年2月至2021年2月青岛市立医院收治的老年女性复杂高危冠心病患者80例,依据治疗方法分为ECMO辅助下PCI治疗组(辅助治疗组)、常规PCI治疗组(常规治疗组),每组各40例。统计分析两组相关临床指标(包括左室射血分数、B型钠尿肽、血红蛋白和血肌酐)、心功能分级、围术期指标(包括支架数量、支架总长度、手术持续时间和住院医疗总费用)、术后并发症发生情况、主要不良心血管事件发生情况。结果治疗后,辅助治疗组患者的左室射血分数、血红蛋白水平均高于常规治疗组,B型钠尿肽、血肌酐水平均低于常规治疗组,差异均有统计学意义(P<0.05)。治疗后,辅助治疗组患者的心功能分级Ⅰ级比率高于常规治疗组,Ⅱ级、Ⅲ级比率均低于常规治疗组,差异均有统计学意义(P<0.05)。辅助治疗组患者的支架数量少于常规治疗组,支架总长度短于常规治疗组,手术持续时间短于常规治疗组,住院医疗总费用低于常规治疗组,差异均有统计学意义(P<0.05)。辅助治疗组患者的术后并发症发生率为15.00%,低于常规治疗组(35.00%),差异有统计学意义(P<0.05)。辅助治疗组患者的主要不良心血管事件发生率为5.00%,明显低于常规治疗组(22.50%),差异有统计学意义(P<0.05)。结论与常规PCI治疗相比,老年女性复杂高危冠心病患者PCI治疗中应用ECMO能有效提高患者的心功能,改善围术期指标,降低并发症和主要不良心血管事件的发生率,有较高的有效性和安全性。
Objective To investigate the efficacy and safety of extracorporeal membrane oxygenation(ECMO)in the Percutaneous coronary intervention(PCI)treatment of elderly women with complex high-risk coronary heart disease.Methods Eighty elderly female patients with complex high-risk coronary heart disease in Qingdao Municipal Hospital from February 2018 to February 2021 were retrospectively selected and divided into two groups according to treatment methods:ecMO-assisted PCI group(adjuvant treatment group)and routine PCI group(routine treatment group),with 40 cases in each group.The related clinical indicators(including left ventricular ejection fraction,B-type natriuretic peptide,hemoglobin and serum creatinine),cardiac function grading,perioperative indicators(including the number of stents,the total length of stents,the duration of surgery and the total cost of hospitalization),postoperative complications and major adverse cardiovascular events of the two groups were statistically analyzed.Results After treatment,the left ventricular ejection fraction and hemoglobin level in the adjuvant treatment group were higher than those in the conventional treatment group,B-type natriuretic peptide and serum creatinine levels were lower than those in conventional treatment group,the differences were statistically significant(P<0.05).After treatment,the proportion of cardiac function gradeⅰin adjuvant treatment group was higher than that in conventional treatment group,the proportion of gradeⅱand gradeⅲwas lower than that of conventional treatment group,the differences were statistically significant(P<0.05).The number of stents in the adjuvant group was less than that in the conventional group,the total length of stent was shorter than that of conventional treatment group,the duration of operation was shorter than that of conventional treatment group,the total cost of inpatient treatment was lower than that of conventional treatment group,the differences were statistically significant(P<0.05).The incidence of postoperative co
作者
马玉容
石岩
于旻
MA Yu-rong;SHI Yan;YU Min(Minimally Invasive Interventional Therapy Center,Qingdao Municipal Hospital,Qingdao Shandong 266000,China)
出处
《临床和实验医学杂志》
2022年第14期1530-1533,共4页
Journal of Clinical and Experimental Medicine
基金
山东省医药卫生科技发展计划项目(编号:2016-WS0317)
青岛市医药卫生科研计划项目(编号:2021-WJZD013)。
关键词
复杂高危冠心病
老年女性
体外膜肺氧合
PCI
心功能
并发症
主要不良心血管事件
Complex high-risk coronary heart disease
Elderly women
Extracorporeal membrane oxygenation
PCI
Cardiac function
Complications
Major adverse cardiovascular events
