小外径球囊保护冠脉分叉病变分支的临床分析

发布时间：2018-01-10 18:26

本文关键词：小外径球囊保护冠脉分叉病变分支的临床分析　出处：《新疆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探索治疗冠脉分叉病变时主支植入药物涂层支架同时小球囊保护分支的介入策略的即刻疗效及安全性。方法:回顾性观察48例冠脉分叉病变用主支植入药物涂层支架同时小球囊保护分支介入策略的病例的影像学效果、临床效果及安全性。影像学效果用治疗前后主支及分支的狭窄改善程度表示;临床效果用即刻发生主要不良心血管事件(MACEs)(Major Adverse Cardiac Events)(心绞痛、急性心肌梗死、靶血管血运重建、死亡)比例来表示。安全性用主支支架球囊及分支小球囊释放的压力、分支闭塞的比例、禁锢球囊及导丝滞留比例来表示。结果:影像学效果:主支术前的狭窄程度为86.80%?9.10%,术后的狭窄程度为0.20%?0.80%,z=-6.08,P0.01;分支术前的狭窄程度为67.10%?20.00%,分支术后的狭窄程度为27.30%?18.20%,z=-5.99,P0.01。临床效果:MACEs的发生比例为0。安全性:分支闭塞的比例、禁锢球囊滞留的比例、禁锢导丝滞留的比例均为0,分支保护球囊以10.00atm?2.70atm进行扩张,主支的支架以15.10atm?1.80atm释放可使分支被禁锢的球囊、导丝顺利撤出。结论:应用主支植入药物涂层支架同时小球囊保护分支的冠脉介入策略,即刻的临床效果及影像学效果好。分支保护球囊以10.00atm?2.70atm进行扩张,主支的支架以15.10atm?1.80atm释放时,该冠脉介入方法安全性较高。但长期的疗效及安全性仍需进行进一步研究。
[Abstract]:Objective: to explore the immediate efficacy and safety of drug coated stent implantation in the treatment of coronary bifurcation. The imaging effects of 48 cases of coronary artery bifurcation with drug-coated stent implanted with main branch and small balloon protecting branch intervention strategy were retrospectively observed. Clinical efficacy and safety. The imaging effects were expressed by the degree of improvement of the stenosis of the main branches and branches before and after treatment. The clinical results were as follows: major adverse cardiovascular events occurred immediately: major Adverse Cardiac events (angina pectoris, acute myocardial infarction). The safety was expressed by the pressure released by the main branch stent balloon and the branch small balloon, and the proportion of branch occlusion. Results: imaging results: the degree of stenosis of the main branch before operation was 86.80? The degree of stenosis after operation was 0.20? The degree of stenosis before branch operation was 67.10? 20.00, the degree of stenosis after branch operation is 27.30? 18.20 the ratio of clinical effect:% MACEs was 0. Safety: the proportion of branch occlusion and the proportion of entrapment of balloon. The proportion of the entrapment was 0, and the branching protection balloon was 10.00 atm? 2.70 ATM expansion, the main branch of the stent with 15.10 atm? The release of 1.80atm could make the entrapment balloon and the guide wire withdraw smoothly. Conclusion: the main branch implantation of drug-coated stent and the small balloon can protect the coronary intervention strategy of the branch. Immediate clinical and imaging results were good. 2.70 ATM expansion, the main branch of the stent with 15.10 atm? When 1.80 ATM was released, the coronary intervention method was more safe, but the long-term efficacy and safety still needed to be further studied.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.4

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