经皮激光心肌血运重建术的初步临床应用(附14例报告)Effect evaluation of percutaneous laser myocardial revascularization in fourteen Chinese patients with refractory angina pectoris
卢才义,魏璇,黄丛春,刘朝中,毛树森,朴龙松,刘姝英,杨淑惠,齐志荣
摘要(Abstract)：
目的 初步评价采用钬：ＹＡＧ激光器及其导管系统对冠心病患者行经皮激光心肌血运重建治疗（ＰＭＲ）的方法学和临床疗效。方法 １４例病人均为男性，平均年龄（６３．３ ± ７．５）岁，心绞痛史（７．３±７．０）年。病例选择标准：①药物治疗无效的Ⅲ、Ⅳ级心绞痛；②冠状动脉病变不宜作经皮冠状动脉腔内成形术（ＰＴＣＡ）或冠状动脉旁路移植术；③左室射血分数（ＬＶＥＦ）≥４５％；④６个月内无心肌梗死病史；⑤心电图、平板试验或ＥＣＴ检查有心肌缺血证据；⑥超声检查左室壁最大舒张期厚度≥８ｍm。操作方法：先作ＲＡＯ30°和ＬＡＯ60°左室造影，冻结在最大舒张期作为定位参照；将激光系统心电同步调整在Ｔ波易损期前３0ｍs，校正实际激光能量；经大腔引导管送入激光导管，对缺血左心室壁进行激光打孔，深度控制在６ｍm以内；在屏幕上标示出打孔部位和序号以保护打孔均匀。随访观察心绞痛级别、心电图、心脏超声、ＥCT、心肌酶等。结果 每例平均打孔（１７．５ ± ４．１）个，发放脉冲（６８．１± ９．３）个，能量（ １３５．８ ± １８．２）Ｊ．ＰＭＲ操作中病人无不适，操作时间（ ８７．５ ± ２４．３） min， Ｘ线透视时间（２３．5±７．６）min。未发生心包填塞等并发症。随访（
关键词(KeyWords)： 激光;心肌血运重建术;心绞痛
基金项目(Foundation):
作者(Author): 卢才义,魏璇,黄丛春,刘朝中,毛树森,朴龙松,刘姝英,杨淑惠,齐志荣
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