陈绍良,方唯一,魏盟,何奔,张瑞岩,陈韵岱,张俊杰,叶飞,朱中生,林松,单守杰,杨松,钱均,Damras,Michael Lee,Tan Huaycheem,Tejas Patel

• 1:南京医科大学附属南京市第一医院 南京市心血管病医院心内科
• 2:上海胸科医院心内科
• 3:上海市第六人民医院心内科
• 4:上海仁济医院心内科

摘要(Abstract)：

目的检验作者改良的DK Crush技术能否确保最终对吻扩张的成功。方法本研究属于连续、非随机和开放式研究,共入选了88例真性分叉病变(分支血管直径>2.0mm)的患者。其中2004年10月至2005年1月间入选的44例患者接受经典Crush技术治疗,2005年1月至2005年6月间入选的44例患者接受DK Crush技术治疗。比较两组患者术前、术中和术后30d内的诸项参数。结果DK Crush组与经典Crush组比较,患者分支血管病变长度长(13.5±3.4mm比7.8±3.1mm,P<0.05)、经皮冠状动脉介入术需时短(44±12min比68±17min,P<0.05)、最终对吻扩张成功率高(100%比70%,P<0.01)、使用球囊数量少(1.6±0.4个比2.7±0.7个,P<0.05)及造影剂使用量小(102±38mL比176±46mL,P<0.05)。DKCrush组与经典Crush组患者的主干与分支血管之间的夹角[(57±18)°比(47±15)°],主干血管病变长度(24.3±8.6mm比21.1±7.3mm)差异均无统计学意义(P均>0.05)。经典Crush组有两例(4.3%)最终对吻失败的患者出现亚急性血栓栓塞。DK Crush组术后即刻分支血管开口部位最小血管直径显著大于经典Crush组(3.01±0.13mm比2.74±0.12mm,P<0.01),而残余狭窄却显著小于后者(7.3%±8.6%比17.4%±11.2%,P<0.05)。经典Crush组有5例患者术后即刻分支血管开口残余狭窄>30%(对吻失败)。结论经典Crush技术存在的技术缺陷是导致预后不良的主要原因。改良的DK Crush技术能显著提高对吻扩张的成功率,进一步的随机研究可以明确后者的有效性。

关键词(KeyWords)： 冠状动脉疾病;血管成形术,经腔,经皮冠状动脉;支架

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈绍良,方唯一,魏盟,何奔,张瑞岩,陈韵岱,张俊杰,叶飞,朱中生,林松,单守杰,杨松,钱均,Damras,Michael Lee,Tan Huaycheem,Tejas Patel

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