摘要
目的研究血管内超声(IVUS)指导下介入治疗对老年冠脉重度钙化病变的临床价值。方法选取2019年6月至2021年2月驻马店市中心医院接受介入治疗的60例老年冠脉重度钙化患者为样本进行回顾性研究,其中34例患者采用IVUS引导进行治疗(IVUS组),26例患者在冠状动脉造影(CAG)指导下进行治疗(CAG组),比较两组介入治疗相关资料、手术成功率、病变冠脉相关参数及主要不良心血管事件(MCAE)发生率。结果IVUS组旋磨次数明显低于CAG组(P<0.05);IVUS组和CAG组手术成功率分别为94.12%和80.77%(P>0.05);两组治疗后最小管腔直径和管腔有效面积明显增加(P<0.05),管腔狭窄率明显降低(P<0.05),且IVUS组最小管腔直径和管腔有效面积高于CAG组,管腔狭窄率低于CAG组(P<0.05);随访结果显示术后30 d内,IVUS组发生急性心肌梗死1例(2.94%),CAG组发生支架内血栓1例(3.85%),急性心肌梗死2例(7.69%),两组比较差异无统计学意义(P>0.05)。结论老年冠脉重度钙化患者采用IVUS指导下介入治疗可为旋磨头、球囊和支架选择提供准确参考依据,提升管腔直径,降低管腔狭窄率,疗效和安全性较CAG指导下介入治疗具有一定优势。
【Objective】To study the clinical value of interventional therapy guided by intravascular ultrasound(IVUS)in elderly patients with severe coronary calcification.【Methods】A retrospective study was conducted on 60 elderly patients with severe coronary artery calcification who received interventional therapy in our hospital from June 2019 to February 2021.Among them,34 patients were treated under IVUS guidance(IVUS group)and 26 patients were treated under the guidance of coronary angiography(CAG group).The interventional treatment related data,operation success rate,the related parameters of diseased coronary artery and the incidence of major adverse cardiovascular events(MCAE)were compared between the two groups.【Results】The number of rotary grinding in IVUS group was significantly lower than that in CAG group(P<0.05).The success rates of IVUS group and CAG group were 94.12%and 80.77%respectively(P>0.05);After treatment,the minimum lumen diameter and effective lumen area increased significantly(P<0.05),and the lumen stenosis rate decreased significantly(P<0.05).The minimum lumen diameter and effective lumen area in IVUS group were higher than those in CAG group,and the lumen stenosis rate was lower than that in CAG group(P<0.05);The follow-up results showed that within 30 days after operation,there was 1 case of acute myocardial infarction(2.94%)in IVUS group,1 case of stent thrombosis(3.85%)and 2 cases of acute myocardial infarction(7.69%)in CAG group.There was no significant difference between the two groups(P>0.05).【Conclusion】Interventional therapy under the guidance of IVUS in elderly patients with severe coronary artery calcification can provide accurate reference basis for the selection of rotary grinding head,balloon and stent,improve the lumen diameter and reduce the lumen stenosis rate.The curative effect and safety have certain advantages over interventional therapy under the guidance of CAG.
作者
刘豪
刘新锋
关玲霞
LIU Hao;LIU Xinfeng;GUAN Lingxia(Department of Cardiovascular Medicine,Zhumadian Central Hospital,Zhumadian,Henan 463000,China)
出处
《中国医学工程》
2022年第12期114-117,共4页
China Medical Engineering
关键词
冠状动脉
钙化
重度
介入治疗
血管内超声
冠状动脉造影
coronary artery
calcification
severe
interventional therapy
intravascular ultrasound
coronary angiography
