拘禁球囊技术（JBT）与边支导丝保护技术（JWT）在分叉病变介入治疗中的即刻效果及安全性对比研究

发布时间：2018-06-19 06:20

本文选题：边支导丝保护技术 + 拘禁球囊技术　；参考：《济南大学》2017年硕士论文

【摘要】：目的:旨在研究观察边支导丝保护技术(JWT)与拘禁球囊技术(JBT),在冠状动脉粥样硬化性心脏病介入治疗真分叉病变(leferve分型Ⅰ型)分支保护中的临床疗效及安全性,为真分叉病变的介入治疗及处理寻找一种更为有效的策略和临床理论依据。方法:选择济宁市第一人民医院心内科接受冠状动脉造影(CAG)证实为冠心病真分叉病变(leferve分型Ⅰ型),并接受PCI治疗的100例患者,随机分为两组:A组:边支导丝保护组(50例);B组:拘禁球囊组(50例),通过观察:(1)术后两组患者即刻效果,比较两组手术边支血管残余狭窄程度、分支有无闭塞或夹层,最终的冠状动脉血流TIMI分级及住院期间主要心脏不良事件(包括心绞痛发作、AMI、心源性死亡)发生率;(2)手术曝光时间、造影剂用量、手术耗材;(3)接受PCI术后1年内不良心血管事件(MACE);两组进行统计学分析,从而对其有效性及安全性进行评价。结果:边支导丝保护组术中发生1例分支闭塞,拘禁球囊组发生0例分支闭塞,边支导丝保护组出现分支血管闭塞现象1例(术后1年),拘禁球囊组0例,两组组间比较无统计学意义,但拘禁球囊组缩短了曝光时间,减少了造影剂用量(P0.05)。术后1年,两组间边支血管开口狭窄程度无显著性差异(P0.05),两组间主支血管再狭窄和MACE发生率比较无统计学意义。结论:拘禁球囊技术(JBT)较边支导丝保护技术(JWT)在近期随访疗效及即刻手术效果不劣于传统边支导丝保护技术,但JBT技术在缩短手术曝光时间,避免PCI术并发症及造影剂用量上有一定优势,在处理冠状动脉分叉病变中安全有效。
[Abstract]:Objective: to study the clinical efficacy and safety of JWT-JWT-JBT and JBT in the treatment of true branching diseases of coronary atherosclerotic heart disease by interventional therapy. To find a more effective strategy and clinical theoretical basis for interventional treatment and management of true bifurcation lesions. Methods: 100 patients who received coronary angiography (CAG) and confirmed by coronary angiography (CAG) as true bifurcation lesions of coronary heart disease were selected and treated by PCI. Two groups were randomly divided into two groups: group B (50 cases) and group B (50 cases): the control group (50 cases). The immediate effect of the two groups was observed after operation. The degree of residual stenosis of the collateral vessels, whether the branches were occluded or dissected, were compared between the two groups. The final coronary blood flow TIMI grading and the incidence of major adverse cardiac events (including angina pectoris, AMI, cardiogenic death) during hospitalization were as follows: operative exposure time, dosage of contrast media, The adverse cardiovascular events within 1 year after PCI were analyzed statistically in the two groups to evaluate their efficacy and safety. Results: one case of branch occlusion occurred during operation in the side branch guide wire protection group, 0 cases in the detention balloon group, 1 case in the side branch guide wire protection group (1 year after operation, 0 cases in the detention balloon group), 1 case in the side branch guide wire protection group, 1 case in the detaining balloon group, 1 case in the side branch guide wire protection group. There was no significant difference between the two groups, but the exposure time was shortened and the dosage of contrast agent was decreased in the detention balloon group. 1 year after operation, there was no significant difference in the degree of stenosis between the two groups. There was no significant difference in the incidence of restenosis and Mace between the two groups. Conclusion: JBT is no worse than JBT in recent follow-up and immediate operation, but JBT can shorten the exposure time. It is safe and effective in the treatment of coronary artery bifurcation disease to avoid complications of PCI and dosage of contrast agent.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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