新器械应用对慢性完全闭塞病变患者介入治疗的作用Effect of using new devices on patients undergoing PCI with chronic total occlusion
韩雅玲,张剑,荆全民,王守力,马颖艳,栾波,王耿
摘要(Abstract)：
目的探讨新器械应用对慢性完全闭塞病变(CTO)患者介入治疗的作用。方法选取1999年1至12月行经皮冠状动脉介入治疗(PCI)的CTO患者52例作为早期组,选取2004年1至12月行PCI治疗的CTO患者174例作为近期组,回顾性比较两组临床、影像学特征及其应用指引导管、首选球囊、首选导丝和特殊导丝技术情况。结果近期组的CTO闭塞时间,合并糖尿病、高血压病、心力衰竭患者比例均大于早期组(29.7±13.0个月比23.9±10.4个月,28.7%比7.7%,59.8%比30.8%,28.7%比9.6%,P均<0.05)。近期组的病例成功率为91.4%(159/174),高于早期组的80.8%(42/52,P<0.05)。早期和近期PCI治疗成功组的CTO靶血管分布差异无统计学意义(P>0.05),近期成功组的刀切状、有桥侧支、闭塞段≥15mmCTO的比例均高于早期成功组(50.3%比31.0%,37.1%比19.0%,73.0%比54.8%,P均<0.05),同时近期成功组亲水涂层导丝、锥形导丝和特殊导丝技术应用的比例均高于早期成功组(20.1%比7.1%,54.1%比0,50.3%比0,P均<0.05)。结论近期组CTO患者临床病情严重程度、病变复杂程度较早期组患者明显增加,但仍保持了较高的病例成功率,提示新器械的应用使CTO病变的PCI适应证范围明显扩大。
关键词(KeyWords)： 冠心病;血管成形术,经腔,经皮冠状动脉;慢性完全闭塞
基金项目(Foundation): 中国人民解放军九五攻关面上课题(A96M002)
作者(Author): 韩雅玲,张剑,荆全民,王守力,马颖艳,栾波,王耿
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