边支球囊潜埋技术与传统导丝保护治疗冠心病真性分叉病变的临床观察

发布时间：2019-06-15 15:32

【摘要】：目的:比较冠脉真性分叉病变在进行主支支架植入术时,边支球囊潜埋与边支导丝保护2种方法对边支的保护效果。方法:44例冠脉真分叉病变患者,随机分为球囊潜埋组(20例)和导丝保护组(24例)。比较两组边支开口受累及率、边支开口严重累及率、边支丢失率、导丝交换时间、完成导丝交换所接受X线暴露量及造影剂用量、术后血清高敏肌钙蛋白T(TNT-h)升高率、术后缺血性胸痛发生率。结果:两组边支开口受累及率、边支丢失率、术后缺血性胸痛发生率差异无统计学意义;两组边支开口严重累及率、导丝交换时间、X线暴露量、造影剂用量、术后血清TNT-h升高率差异有统计学意义(P0.05);术后随访8~12个月,两组术后主要心血管不良事件的发生率差异无统计学意义。结论:在真性分叉病变介入治疗中,边支球囊潜埋技术较导丝保护技术可以明显减轻因斑块变形、移位造成的边支开口受累及的严重程度,保证交换导丝顺利,缩短手术时间,减少X线暴露量,减少造影剂用量,减少心肌损伤,且不增加术后主要心血管不良事件的发生率。
[Abstract]:Objective: To compare the protective effect of two methods on the protection of the side branch by the side-branch balloon and the side-supported guide wire during the main stent implantation. Methods:44 patients with real bifurcation lesions were randomly divided into two groups (20 cases) and guide wire protection group (24 cases). The incidence of high-sensitivity troponin T (TNT-h) and the rate of post-operative ischemic chest pain were compared between the two groups of side branch opening involvement and rate, the severity of the side branch opening, the loss rate of the side branch, the time of the wire exchange, the completion of the guidewire clearinghouse, the X-ray exposure and the amount of the contrast agent. Results: There was no significant difference in the incidence of the two groups of side branch openings, the rate of side branch loss and the rate of postoperative ischemic chest pain. The severity of the two groups of side branch openings, the time of wire exchange, the amount of X-ray exposure, the amount of contrast agent and the difference of the increase of TNT-h in the two groups were statistically significant (P0.05). The incidence of major cardiovascular adverse events in the two groups was not significant after the follow-up period of 8 to 12 months. Conclusion: In the interventional treatment of true bifurcation lesions, the technique of wire protection of the side branch balloon can significantly reduce the extent of the involvement and severity of the side branch opening caused by the deformation and displacement of the plaque, ensure the smooth of the exchange guide wire, shorten the operation time and reduce the exposure of the X-ray. Reduces the amount of contrast agent, reduces myocardial damage, and does not increase the incidence of major cardiovascular adverse events after surgery.
【作者单位】：南京医科大学第一附属医院心内科;宿迁市第一人民医院心内科;
【基金】：江苏省高校“青蓝工程”科技创新团队带头人科研项目(苏教师[2012]39号) 南京市科技局科技社会发展重点项目(2014SC517076)
【分类号】：R541.4

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