摘要
目的探讨“一站式介入”治疗[同期左心耳封堵联合经皮冠状动脉介入(PCI)治疗]在心房颤动合并冠心病患者中的安全性和有效性,为临床治疗心房颤动合并冠心病患者提供参考。方法选取2014年8月—2022年11月于陆军军医大学第一附属医院心血管内科住院的56例房颤合并冠心病患者为研究对象,将同期行左心耳封堵和PCI治疗的17例患者作为一站式介入组,将分期手术的39例患者作为非一站式介入组。收集2组患者的性别、年龄、合并基础疾病等一般资料及经胸心脏超声(TTE)和经食道心脏超声(TEE)等检查结果,随访患者术后缺血性脑卒中、大出血、器械相关血栓(DRT)、心衰再住院等发生情况。结果2组患者美国纽约心脏病学会(NYHA)心功能分级Ⅲ级所占比例及低密度脂蛋白胆固醇(LDL-C)水平比较,差异均有统计学意义(χ^(2)=4.016,P=0.045;t=2.305,P=0.025);2组患者年龄、性别构成、吸烟及饮酒比例、合并高血压病比例、合并糖尿病比例、合并外周动脉硬化比例、CHA2DS2-VASc评分、HAS-BLED评分等资料比较,差异均无统计学意义(P>0.05)。一站式介入组和非一站式介入组患者左心耳最大宽度分别为(20.76±3.05)mm和(20.49±2.38)mm,左心耳最大深度分别为(27.18±4.98)mm和(27.26±4.58)mm,差异均无统计学意义(t=0.367、0.058,P=0.715、0.954);一站式介入组和非一站式介入组患者植入左心耳封堵器直径分别为(26.65±2.98)mm和(26.54±3.41)mm,差异无统计学意义(t=0.114,P=0.910);一站式介入组和非一站式介入组患者植入支架数量分别为(1.00±0.00)个和(1.26±0.55)个,差异有统计学意义(t=2.919,P=0.006);2组患者左心耳封堵术后残余分流发生情况比较,差异无统计学意义(χ^(2)=1.057,P=0.229)。2组患者术前和术后3个月左房(LA)前后径、右房(RA)横径、左室(LV)前后径、右室(RV)前后径和左室射血分数(LVEF)比较,差异均无统计学意义(P>0.05)。2组
Objective To explore the safety and efficacy of"One-Stop Intervention"treatment[simultaneous left atrial appendage closure combined with percutaneous coronary intervention(PCI)]in patients with atrial fibrillation comorbid with coronary heart disease,and provide evidence for clinical treatment of these patients.Methods A total of 56 patients with atrial fibrillation and coronary heart disease admitted to the Department of Cardiology of The First Affiliated Hospital of Army Medical University from August 2014 to November 2022 were selected as the study participants.Among them,17 patients who underwent simultaneous left atrial appendage closure and PCI were assigned to the One-Stop Intervention group,and 39 patients who underwent staged surgery were assigned to the non-One Stop Intervention group.General information such as gender,age,and underlying diseases,as well as examination results of transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE),were collected for both groups.The occurrence of postoperative ischemic stroke,major bleeding,device-related thrombus(DRT),and heart failure readmission was followed up.Results Significant differences were observed in the proportion of patients with New York Heart Association(NYHA)functional class III and LDL-C levels between the two groups(χ^(2)=4.016,P=0.045;t=2.305,P=0.025).No significant differences were found in age,gender composition,smoking and drinking rates,proportions of hypertension,diabetes,peripheral arterial disease,CHA2DS2-VASc score,HAS-BLED score,and other data between the two groups(P>0.05).The maximum width of left atrial appendage implantation in the One-Stop Intervention group and the non-One Stop Intervention group was(20.76±3.05)mm and(20.49±2.38)mm,respectively,and the maximum depth was(27.18±4.98)mm and(27.26±4.58)mm,respectively,with no significant differences(t=0.367,0.058,P=0.715,0.954).The diameter of the left atrial appendage closure device in the One-Stop Intervention group and the non-One Stop Intervention group was
作者
颜文
许祥
万陈
刘锋
姚青
王斌斌
刘力萍
宋玲
宋治远
李华康
Yan Wen;Xu Xiang;Wan Chen;Liu Feng;Yao Qing;Wang Binbin;Liu Liping;Song Ling;Song Zhiyuan;Li Huakang(Department of Cardiology,The First Affiliated Hospital of Army Medical University,Chongqing 405200,China)
出处
《保健医学研究与实践》
2024年第2期52-58,共7页
Health Medicine Research and Practice
基金
重庆市科卫联合医学科研项目面上项目(2023MSXM146)。
