摘要
目的 :总结高龄冠心病介入治疗的经验。方法 :回顾分析我院 1997年 2月至 2 0 0 1年 12月连续 12 6例 70岁以上的冠心病病人的介入治疗资料 ,其中多支病变占 89 7%。 193处靶病变行PTCA、冠状动脉支架、切割球囊扩张和旋磨 ,其中复杂病变占 86 5 %。结果 :病例成功率 95 2 % ,病变成功率93 3%。其中 33例急性心肌梗死介入治疗梗塞相关血管开通率 10 0 %。慢性闭塞病变 2 1处 ,成功率81 0 %。 112例病人行冠状动脉支架术 (占 88 9% )。术前靶血管平均狭窄 (85 6± 11 3) % ,术后平均残余狭窄 (5 2± 6 1) %。严重并发症率 4 0 % ,其中死亡率 2 4 %。 1例 (0 8% )行紧急冠脉架桥术 ;1例(0 8% )Q波心梗。急性闭塞 5例 (4 0 % ) ,心包填塞 1例 (0 8% ) ;5例 (4 0 % )病人出现消化道出血 ,1例(0 8% )病人发生脑出血。结论 :70岁以上的高龄冠心病人的介入治疗成功率高。
Objective:To summarize the primary outcome of percutaneous coronary intervention (PCI) in patients over the age of 70 years (mean age 74 9).Method:Between February 1997 and December 2001,a total retrospective cohort study of 126 consecutive patients aged 70 years or older underwent PTCA,coronary stenting,cutting ballon angioplasty or rotational atherectomy,113 of whom with multivessel coronary disease (89 7%),13 5% with left ventricular dysfunction.167 of 193 target lesions were complex lesions (86\^5%).Result:The primary patient success rate was 95\^2%,and primary lesion success rate was 93\^3%.33 infarct\|related arteries in patients with AMI were successfully revascularizationed (100%).Procedural success rate in 21 chronic total occlusions was 81 0%.112 patients underwent coronary stenting.The mean percent diameter stenosis was reduced from (85 6±11 3)% to (5\^2±6\^1)%.Significant complications were encountered in 5 patients (4 0%):3 mortalities (2\^4%),1 Q\|wave infarction (0 8%),and 1 emergency coronary bypass operation (0.8%).The rate of abrupt closure was 4.5%.There were 1 pericardial tamponade and 6 bleeding complications,including 5 digestive tract hemorrhage,1 intracranical hemorrhage.Conclusion:PCI can be performed in patients over age 70 with a good success rate,an acceptable complication rate.
出处
《心肺血管病杂志》
CAS
2003年第1期23-25,共3页
Journal of Cardiovascular and Pulmonary Diseases
