摘要
目的:评估经皮冠状动脉介入治疗(PCI)对冠状动脉慢性完全闭塞(CTO)患者的治疗效果,并探讨影响介入治疗效果的相关因素。方法:回顾性分析586例经PCI治疗的CTO患者的临床资料,分析CTO患者行PCI治疗的疗效及相关影响因素。结果:CTO患者PCI的成功率为80%。术中并发症7.7%,分别是冠状动脉穿孔8例,心包压塞5例,支架血栓形成4例,严重心律失常(房扑、房颤、室性心动过速及室颤)22例,手术相关心绞痛6例。影响PCI治疗成功的患者自身因素有年龄(P=0.034)、高血压史(P=0.041)、糖尿病史(P=0.032)、发病至治疗的时间(P=0.008);病变相关因素有冠脉闭塞部位(P<0.05)、冠脉分支迂曲程度(P=0.015)、闭塞血管远端缺如(P=0.044)及合并钙化(P=0.007)。结论:CTO患者进行PCI治疗的效果良好。患者的个人病史、病变特点及治疗是否及时是决定介入治疗成功的关键因素。
Objective:To evaluate the effect of percutaneous coronary intervention (PCI) in patients with coronary chronic total occlusion (CTO),and to explore the influencing factors of interventional therapy.Methods:The clinical data of 586 cases with CTO underwent PCI were analyzed retrospectively.The effects and influencing factors were compared and analyzed.Results:The success rate of PCI was 80%.Intraoperative complications were few (7.7%),including 8 cases of coronary artery perforation during operation,5 cases of cardiac tamponade,4 cases of stent thrombosis,22 cases of severe arrhythmia (atrial flutter,atrial fibrillation,ventricular tachycardia and ventricular fibrillation),and 6 cases of operation related angina.The patients'personal factors which influenced the treatment were age (P =0.034),history of hypertension (P =0.041),history of diabetes mellitus (P =0.032),and the length of time from onset to treatment (P =0.008).The factors related with the lesions included the location of coronary occlusion (P 〈 0.05),the tortuousness of coronary artery (P =0.015),the distal defect (P =0.044) and calcification (P =0.007) of occluded vessels.Conclusion:PCI shows a good effect on patients with CTO.The patients'personal history,pathological features of the disease and in time for treatment are key factors that influence the success of PCI.
出处
《内科急危重症杂志》
2014年第6期369-372,共4页
Journal of Critical Care In Internal Medicine
基金
上海市卫生局青年课题(No:20134y116)
关键词
冠状动脉慢性完全闭塞
介入治疗
疗效
Coronary chronic total occlusion
Percutaneous coronary intervention
Curative effect